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General NPI Number Information
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NPI Number | 1902625924
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Entity Type | Organization
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Legal Business Name | SANTA ROSA HEALTHCARE INC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 1026 4TH ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-4330
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Country | US
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Telephone | 707-341-5200
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Fax | 707-341-5201
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Provider Business Mailing Address
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Address Line | 1026 4TH ST
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City | SANTA ROSA
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State | CA
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Zip | 95404-4330
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Country | US
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Telephone | 707-341-5200
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Fax | 707-341-5201
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Authorized Official
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Title or Position | PIC
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Name | NIMESH CHAMPAKLAL GANDHI
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Credential | RPH
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Telephone | 707-341-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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