Provider Demographics
NPI:1407657869
Name:CC CARE RX INC
Entity type:Organization
Organization Name:CC CARE RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/DIRECTOR/PIC
Authorized Official - Prefix:
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FALAHATI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:661-753-3290
Mailing Address - Street 1:23928 LYONS AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2454
Mailing Address - Country:US
Mailing Address - Phone:661-753-3290
Mailing Address - Fax:661-753-3291
Practice Address - Street 1:23928 LYONS AVE STE 110
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2454
Practice Address - Country:US
Practice Address - Phone:661-753-3290
Practice Address - Fax:661-753-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59575OtherBOARD OF PHARMACY