Organization
REBEL DISTRIBUTORS
Active
Other names
Physician Partner/Pharmacy Partner
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DESTRY SETSER (CEO/OWNER)
(877) 732-3579
Entity
Organization
Contact information
Practice address
3607 OLD CONEJO RD, THOUSAND OAKS, CA 91320-2123
(805) 214-0900
(805) 214-0950
Mailing address
3607 OLD CONEJO RD, THOUSAND OAKS, CA 91320-2123
(805) 214-0900
(805) 214-0950
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
WLS3004
CA
332B00000X
Durable Medical Equipment & Medical Supplies
WLS3004
CA
Other
Enumeration date
05/11/2007
Last updated
02/03/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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