Organization
ROSE PHARMACY SA, LLC
Active
Parent organization
OPTIORX, LLC
Other names
ROSE PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
OPTIORX, LLC
Authorized official
LEO LAFRANCO (CFO)
(630) 242-8969
Entity
Organization
Contact information
Practice address
1220 W HEMLOCK WAY, STE #110, SANTA ANA, CA 92707
(714) 662-0548
(714) 662-0549
Mailing address
1220 W HEMLOCK WAY, STE #110, SANTA ANA, CA 92707
(714) 662-0548
(714) 662-0549
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215026711
—
CA
01
—
5659140001
MEDICARE
—
01
—
57774
CA BOARD OF PHARMACY
CA
01
—
N-6PJ14H
HQAA
—
Enumeration date
10/12/2006
Last updated
09/24/2024
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