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General NPI Number Information
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NPI Number | 1568936961
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Entity Type | Organization
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Legal Business Name | ANGEL ROSE LTC PHARMACY INC
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 365 W 2ND AVE STE 103
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City | ESCONDIDO
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State | CA
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Zip | 92025-4136
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Country | US
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Telephone | 442-286-7127
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Fax | 442-286-7113
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Provider Business Mailing Address
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Address Line | 365 W 2ND AVE STE 103
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City | ESCONDIDO
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State | CA
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Zip | 92025-4136
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Country | US
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Telephone | 442-286-7127
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Fax | 442-286-7113
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Authorized Official
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Title or Position | CEO/PHARMACIST-IN-CHARGE
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Name | ROSALINA BRAVO CANTURIA
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Credential | RPH
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Telephone | 442-286-7127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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