Organization
RADY CHILDREN'S HEALTH SERVICES-SAN DIEGO
Active
Parent organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
Other names
Rady Children's HomeCare Pharmacy, Rady Children's HomeCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADY CHILDREN'S HOSPITAL - SAN DIEGO
Authorized official
KATHLEEN MARIE CAIN CARRITHERS (CHIEF FINANCIAL OFFICER)
(858) 576-1700
Entity
Organization
Contact information
Practice address
8291 AERO PL, SUITE 130, SAN DIEGO, CA 92123-2040
(858) 966-4941
(858) 966-8996
Mailing address
8291 AERO PL, SUITE 130, SAN DIEGO, CA 92123-2040
(858) 966-4941
(858) 966-8996
Taxonomy
Speciality
Code
Description
License number
State
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA450610
—
CA
01
—
ZZZ00279Z
BLUE SHIELD HIP DME
CA
01
—
ZZZ43632Z
BLUE SHIELD HIP
CA
Enumeration date
11/02/2006
Last updated
07/31/2018
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