=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922373638
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAKSHATRA RX SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2012
-----------------------------------------------------
Last Update Date | 01/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 407 E GILBERT ST STE 4
-----------------------------------------------------
City | SAN BERNARDINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92404-5325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-774-5200
-----------------------------------------------------
Fax | 909-774-5204
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7777 MILLIKEN AVE STE 100
-----------------------------------------------------
City | RANCHO CUCAMONGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-774-5200
-----------------------------------------------------
Fax | 909-774-5204
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC
-----------------------------------------------------
Name | MR. NANDALAL SOJITRA
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 646-637-3339
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY50870
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------