1720525793 NPI number — CITY RX PHARMACY, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720525793 NPI number — CITY RX PHARMACY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY RX PHARMACY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720525793
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7643 S. ATLANTIC AVE.
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
CUDAHY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-537-8970
Provider Business Mailing Address Fax Number:
323-537-8991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7643 S. ATLANTIC AVE.
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
CUDAHY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-537-8970
Provider Business Practice Location Address Fax Number:
323-537-8991
Provider Enumeration Date:
01/27/2017

Additional Information

Authorized Official

Authorized Official Last Name:
VEKARIYA
Authorized Official First Name:
VINAY
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/DIR.
Authorized Official Telephone Number:
323-537-8970

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  55473 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2167401 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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