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General NPI Number Information
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NPI Number | 1962739425
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Entity Type | Organization
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Legal Business Name | RANCHO MIRAGE PHARMACY, INC.
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Dates
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Enumeration Date | 11/04/2009
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Last Update Date | 11/04/2009
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Provider Practice Location Address
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Address Line | 72-780 COUNTRY CLUB DR. BLD D-400
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270
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Country | US
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Telephone | 760-340-1130
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Fax | 760-340-1150
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Provider Business Mailing Address
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Address Line | 72-780 COUNTRY CLUB DR. BLD D-400
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270
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Country | US
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Telephone | 760-340-1130
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Fax | 760-340-1150
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. JUDE MENG-FENG HSIEH
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Credential | PHARM.D.
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Telephone | 714-235-4237
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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 | PHY49844
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License Number State | CA
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