Organization
RAINCROSS OUTPATIENT PHARMACY INC
Active
Other names
RAINCROSS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAMESH UPADHYAYULA RPH (OWNER)
(951) 788-4646
Entity
Organization
Contact information
Practice address
4646 BROCKTON AVE, RIVERSIDE, CA 92506-0102
(951) 788-4646
Mailing address
4646 BROCKTON AVE, RIVERSIDE, CA 92506-0102
(951) 788-4646
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
54820
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0567783
OTHER ID NUMBER
—
05
—
PHA419320
—
CA
Enumeration date
07/13/2005
Last updated
12/05/2016
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