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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