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Riteaid 5614

Pharmacy, Community/Retail Pharmacy in Chula Vista, CA. Organization (NPI-2).

NPI number1730202425
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1730202425
Entity type
Organization (NPI-2)
Legal business name
Riteaid 5614
Organization subpart
No
Enumeration date
Apr 9, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy42230CAYes

Practice location

740 Otay Lakes Rd
Chula Vista, CA 91910-6915

Phone 619-421-4872 · Fax 619-421-2452

Mailing address

740 Otay Lakes Rd
Chula Vista, CA 92104-6915

Phone 619-421-4872 · Fax 619-421-2452

Authorized official

Pedro Miguel Sousa
Pharmacy Manager
6194214872

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