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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
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