Organization
RSS PHARMACY ASSOCIATE LLC
Active
Other names
Cole's Village Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIR PATEL (OWNER)
(951) 444-7057
Entity
Organization
Contact information
Practice address
223 E 3RD ST, CORONA, CA 92879-1438
(951) 444-7057
(951) 444-7056
Mailing address
223 E 3RD ST, CORONA, CA 92879-1438
(951) 444-7057
(951) 444-7056
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY50781
CA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132078
PK
—
Enumeration date
09/01/2011
Last updated
10/14/2021
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