Organization
INTRA RX DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BIANCA MARIE BANKS (CEO/OWNER)
(310) 537-4431
Entity
Organization
Contact information
Practice address
809 E ROSECRANS AVE, EAST RANCHO DOMINGUEZ, CA 90221-2145
(310) 537-4431
(310) 537-8592
Mailing address
809 E ROSECRANS AVE, EAST RANCHO DOMINGUEZ, CA 90221-2145
(310) 537-4431
(310) 537-8592
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY 15308
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA153080
—
CA
Enumeration date
07/27/2005
Last updated
10/13/2010
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