=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386058873
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RX RELIEF
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2014
-----------------------------------------------------
Last Update Date | 06/12/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 614 DOUGLAS ST APT D
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93308-2392
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-331-7773
-----------------------------------------------------
Fax | 559-432-2349
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 614 DOUGLAS ST APT D
-----------------------------------------------------
City | BAKERSFIELD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93308-2392
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-331-7773
-----------------------------------------------------
Fax | 559-432-2349
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HUMAN RESOURSES SUPERVISOR
-----------------------------------------------------
Name | MR. FRANCISCO PELAYA
-----------------------------------------------------
Credential | MBA
-----------------------------------------------------
Telephone | 800-797-3543
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Clinic/Center
-----------------------------------------------------
License Number | 39153
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------