Organization
GEN-RX-DRUGS
Active
Other names
GENRX DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ROUZITALAB PHARMACY (RPH)
(951) 674-6836
Entity
Organization
Contact information
Practice address
16800 LAKESHORE DR STE 1, STE 1, LAKE ELSINORE, CA 92530-4909
(951) 674-6836
(951) 674-9973
Mailing address
16800 LAKESHORE DR, STE 1, LAKE ELSINORE, CA 92530-4909
(951) 674-6836
(951) 674-9973
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY39942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306950944
NPI
CA
01
—
1997621
PK
—
05
—
PHA399420
—
CA
Enumeration date
08/19/2006
Last updated
10/25/2019
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