# RODERICK PHARMACY GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** RX EXPRESS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396726634
- **Authorized official:** DAVID RODERICK PHARMD (CEO)
- **Authorized official phone:** (209) 465-1001

## Contact information

- **Practice address:** 711 E MARKET ST, STOCKTON, CA 95202-3104
- **Practice address phone:** (209) 465-1001
- **Practice address fax:** (209) 946-1001
- **Mailing address:** PO BOX 1651, STOCKTON, CA 95201-1651
- **Mailing address phone:** (209) 465-1001
- **Mailing address fax:** (209) 946-1001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHY43891 | CA | Yes |

## Other

- **Enumeration date:** 11/11/2005
- **Last updated:** 09/13/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1992342 | PK | — |
| 05 | — | PHA438910 | — | CA |