Provider Demographics
NPI:1528693603
Name:REMEDYRX PHARMACY
Entity type:Organization
Organization Name:REMEDYRX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:916-740-1600
Mailing Address - Street 1:1420 E ROSEVILLE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3081
Mailing Address - Country:US
Mailing Address - Phone:916-740-1600
Mailing Address - Fax:916-740-1601
Practice Address - Street 1:1420 E ROSEVILLE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3081
Practice Address - Country:US
Practice Address - Phone:916-740-1600
Practice Address - Fax:916-740-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1497181523Medicaid