Provider Demographics
NPI:1174853113
Name:RSF PHARMACY INC
Entity Type:Organization
Organization Name:RSF PHARMACY INC
Other - Org Name:RANCHO SANTA FE PHARMACY & SPIRIT SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAMIDREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SABOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-336-5063
Mailing Address - Street 1:PO BOX 1188
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-1188
Mailing Address - Country:US
Mailing Address - Phone:858-756-3096
Mailing Address - Fax:858-756-4725
Practice Address - Street 1:6056 EL TORDO
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067-1188
Practice Address - Country:US
Practice Address - Phone:858-756-3096
Practice Address - Fax:858-756-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY501613336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5636761OtherNCPDP PROVIDER IDENTIFICATION NUMBER