Organization
DEL RIO SANITARIUM PHARMACY, INC
Active
Other names
Del Rio Sanitarium Pharmacy, Del Rio Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MORNA ROUSE (SEC/DIR DEL RIO SAN. PHARMACY INC)
(562) 927-6586
Entity
Organization
Contact information
Practice address
7004 E GAGE AVE, BELL GARDENS, CA 90201-2014
(562) 927-6586
Mailing address
7004 E GAGE AVE, BELL GARDENS, CA 90201-2014
(562) 927-6586
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY8062
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PH0B80620
—
CA
Enumeration date
10/12/2005
Last updated
08/22/2020
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