Provider Demographics
NPI:1093809493
Name:RCY PHARMACY INC
Entity Type:Organization
Organization Name:RCY PHARMACY INC
Other - Org Name:GEMMEL PHARMACY CUCAMONGA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-847-0878
Mailing Address - Street 1:9349 FOOTHILL BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3567
Mailing Address - Country:US
Mailing Address - Phone:909-987-2518
Mailing Address - Fax:909-980-7306
Practice Address - Street 1:9349 FOOTHILL BLVD
Practice Address - Street 2:STE A
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3567
Practice Address - Country:US
Practice Address - Phone:909-987-2518
Practice Address - Fax:909-980-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY50582333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0506949OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CA6588400001Medicare NSC