Organization
RELIANCE IMPERIAL PHARMACY LLC
Active
Organization
RELIANCE IMPERIAL PHARMACY LLC
Active
Other names
FARMACIA DEL PUEBLO
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAHMAJI VALIVETI RPH (MEMBER/OWNER)
(760) 768-6000
Entity
Organization
Contact information
Practice address
801 E BIRCH ST, STE # 4, CALEXICO, CA 92231-5925
(760) 768-6000
(760) 768-6006
Mailing address
801 E BIRCH ST, STE # 4, CALEXICO, CA 92231-5925
(760) 768-6000
(760) 768-6006
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY50953
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY50953
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY50953
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
04/29/2012
Last updated
10/16/2024
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