Organization
FOOTHILL PHARMACY
Active
Other names
ROBERT OLIVA
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT OLIVA (OWNER AND PHARMACIST)
(909) 874-2385
Entity
Organization
Contact information
Practice address
1850 N RIVERSIDE AVE, SUITE 170, RIALTO, CA 92376-8071
(909) 874-2385
(909) 874-2428
Mailing address
1850 N RIVERSIDE AVE, SUITE 170, RIALTO, CA 92376-8071
(909) 874-2385
(909) 874-2428
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY45239
CA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0538845
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA392680
—
CA
Enumeration date
08/10/2006
Last updated
02/22/2011
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