Organization
PARKVIEW MEDICAL PLAZA PHARMACY INC
Active
Other names
PARKVIEW MEDICAL PLAZA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH UPADHYAYULA (PRESIDENT)
(951) 892-5828
Entity
Organization
Contact information
Practice address
3975 JACKSON ST, STE 109, RIVERSIDE, CA 92503-3901
(951) 637-0180
(951) 637-0183
Mailing address
3975 JACKSON ST, STE 109, RIVERSIDE, CA 92503-3901
(951) 637-0180
(951) 637-0183
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY43137
CA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002122
PK
—
05
—
PHA431370
—
CA
Enumeration date
08/31/2006
Last updated
01/18/2017
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