Organization
RTY PHARMACEUTICAL INC
Active
Other names
BALBOA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT YASMEH (OWNER)
(858) 278-0111
Entity
Organization
Contact information
Practice address
6465 BALBOA AVE STE 101, SAN DIEGO, CA 92111-3124
(858) 278-0111
(858) 278-2512
Mailing address
6465 BALBOA AVE STE 101, SAN DIEGO, CA 92111-3124
(858) 278-0111
(858) 278-2512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY53437
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992769
PK
—
05
—
PHA456330
—
CA
Enumeration date
12/27/2006
Last updated
06/23/2016
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