Provider Demographics
NPI:1043635022
Name:R.D.,L.L.C.
Entity Type:Organization
Organization Name:R.D.,L.L.C.
Other - Org Name:HORIZON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:K
Authorized Official - Last Name:DHRUVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-584-0300
Mailing Address - Street 1:PO BOX 8169
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-0169
Mailing Address - Country:US
Mailing Address - Phone:509-584-0300
Mailing Address - Fax:509-584-0302
Practice Address - Street 1:507 W 1ST ST
Practice Address - Street 2:
Practice Address - City:WAPATO
Practice Address - State:WA
Practice Address - Zip Code:98951-1105
Practice Address - Country:US
Practice Address - Phone:509-584-0300
Practice Address - Fax:509-584-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2036375Medicaid