Organization
SERVRITE DRUG
Active
Organization
SERVRITE DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M LANE (PRESIDENT)
(562) 948-1905
Entity
Organization
Contact information
Practice address
9420 SLAUSON AVE, PICO RIVERA, CA 90660-4748
(562) 948-1905
(562) 948-3017
Mailing address
9420 SLAUSON AVE, PICO RIVERA, CA 90660-4748
(562) 948-1905
(562) 948-3017
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY34009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHA340090
MEDICAL
CA
05
—
PHY34009
—
CA
Enumeration date
12/29/2006
Last updated
08/22/2020
Update your record
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