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NPI Code Detail

MEDICARE: RIDDHI PHARMACY CORPORATION

MEDICARE: RIDDHI PHARMACY CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy50545CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15640912OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1659663235
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIDDHI PHARMACY CORPORATION
Provider Business Mailing Address
First Line : 22635 ALESSANDRO BLVD STE E
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92553-8550
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 22635 ALESSANDRO BLVD STE E
Second Line :
City : MORENO VALLEY
State : CA
Zip : 92553-8550
Country : US
Telephone Number : 951-656-7979
Fax Number : 951-656-7977
Authorized Official
Title or Position : OWNER
Name : RITESH PATEL
Credential :
Telephone Number : 951-656-7979
Provider Enumeration Date : 05/13/2011
Last Update Date : 01/13/2012

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Directions to “RIDDHI PHARMACY CORPORATION ” Practice Location

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