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General NPI Number Information
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NPI Number | 1992240998
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Entity Type | Organization
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Legal Business Name | CAP RX LTC INC
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 507 CENTRAL AVE STE C
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2704
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Country | US
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Telephone | 831-324-6800
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Fax | 831-643-9645
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Provider Business Mailing Address
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Address Line | 507 CENTRAL AVE STE. C
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City | PACIFIC GROVE
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State | CA
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Zip | 93950-2704
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Country | US
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Telephone | 831-324-6800
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Fax | 831-643-9645
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANA GORDON
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Credential | PHARMD
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Telephone | 831-324-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | PHY55297
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License Number State | CA
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