Provider Demographics
NPI:1164304127
Name:SD HEALTHCARE RX INC
Entity type:Organization
Organization Name:SD HEALTHCARE RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIXIT
Authorized Official - Middle Name:D
Authorized Official - Last Name:VADDORIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-313-0200
Mailing Address - Street 1:3030 CHILDRENS WAY STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4226
Mailing Address - Country:US
Mailing Address - Phone:858-313-0200
Mailing Address - Fax:858-313-0202
Practice Address - Street 1:3030 CHILDRENS WAY STE 108
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4226
Practice Address - Country:US
Practice Address - Phone:858-313-0200
Practice Address - Fax:858-313-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY60502OtherBOARD OF PHARMACY