Organization
THEO PHARMACEUTICALS INC
Active
Organization
THEO PHARMACEUTICALS INC
Active
Other names
THEO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAKESH TAMMABATTULA (OWNER)
(347) 515-6789
Entity
Organization
Contact information
Practice address
13701 BEACH BLVD, STE A2, WESTMINSTER, CA 92683-3201
(714) 373-0214
(714) 373-0839
Mailing address
13701 BEACH BLVD STE A2, WESTMINSTER, CA 92683-3201
(714) 373-0214
(714) 373-0839
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
265225
MN
3336C0003X
Community/Retail Pharmacy
NP000794
PA
3336C0003X
Community/Retail Pharmacy
NRP.022668450-03
OH
3336C0003X
Community/Retail Pharmacy
PH03678
NV
3336C0003X
Community/Retail Pharmacy
Primary
PHY53900
CA
3336M0002X
Mail Order Pharmacy
PH30490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162079
PK
—
05
—
8968740
—
CA
Enumeration date
03/31/2014
Last updated
03/01/2017
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