Organization
RIVIERA DRUGS LLC
Active
Other names
Mike's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SHALENDRA CHERUKURI (MEMBER)
(267) 408-2937
Entity
Organization
Contact information
Practice address
8541 FORT SMALLWOOD RD, UNIT G, PASADENA, MD 21122-2676
(410) 255-1800
(410) 255-1900
Mailing address
8541 FORT SMALLWOOD RD STE G, PASADENA, MD 21122-2676
(410) 255-1800
(410) 255-1900
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P05941
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139284
PK
—
Enumeration date
02/21/2013
Last updated
06/23/2016
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