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General NPI Number Information
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NPI Number | 1629359856
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Entity Type | Organization
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Legal Business Name | RSS PHARMACY ASSOCIATE LLC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 223 E 3RD ST
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City | CORONA
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State | CA
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Zip | 92879-1438
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Country | US
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Telephone | 951-444-7057
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Fax | 951-444-7056
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Provider Business Mailing Address
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Address Line | 223 E 3RD ST
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City | CORONA
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State | CA
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Zip | 92879-1438
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Country | US
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Telephone | 951-444-7057
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Fax | 951-444-7056
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Authorized Official
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Title or Position | OWNER
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Name | SAMIR PATEL
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Credential |
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Telephone | 951-444-7057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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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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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY50781
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License Number State | CA
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