Organization
RAAFAT GEORGE GERGES
Active
Other names
DANIEL'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAAFAT GERGES (OWNER AND PIC)
(951) 776-2015
Entity
Organization
Contact information
Practice address
12730 HEACOCK ST STE 1, MORENO VALLEY, CA 92553-3040
(951) 485-1234
(951) 485-3233
Mailing address
12730 HEACOCK ST STE 1, MORENO VALLEY, CA 92553-3040
(951) 485-1234
(951) 485-3233
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5617052
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA473390
—
CA
Enumeration date
06/13/2006
Last updated
05/11/2012
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