=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386865269
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RITT MEDICAL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6283 W LONE CACTUS DR
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85308-6304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-974-4501
-----------------------------------------------------
Fax | 623-547-5807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1115
-----------------------------------------------------
City | SUN CITY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85372-1115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 623-974-4501
-----------------------------------------------------
Fax | 623-547-5807
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. GERALD G RITT
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 623-974-4501
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number | 1125194
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------