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NPI Code Detail

MEDICARE: MR. GEORGE GIARRUSSO B.S. PHARMACY

MEDICARE: MR. GEORGE GIARRUSSO B.S. PHARMACY
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
1183500000XPharmacistRPH36573CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RPH36573OTHERCACALIFORNIA BOARD OF PHARMACY LICENSE NUMBER

General Provider Information

NPI Number : 1669759585
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GEORGE GIARRUSSO B.S. PHARMACY
Provider Business Mailing Address
First Line : 4710 HORSESHOE LN
Second Line :
City : RIVERSIDE
State : CA
Zip : 92509-7100
Country : US
Telephone Number : 951-681-8442
Fax Number : 951-681-8442
Provider Business Practice Location Address
First Line : 8044 LIMONITE AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92509-6107
Country : US
Telephone Number : 951-685-0139
Fax Number : 951-685-0154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2011
Last Update Date : 11/06/2011

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