Organization
RITEAID 5614
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEDRO MIGUEL SOUSA PHARM.D. (PHARMACY MANAGER)
(619) 421-4872
Entity
Organization
Contact information
Practice address
740 OTAY LAKES RD, CHULA VISTA, CA 91910-6915
(619) 421-4872
(619) 421-2452
Mailing address
740 OTAY LAKES RD, CHULA VISTA, CA 92104-6915
(619) 421-4872
(619) 421-2452
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
42230
CA
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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