Provider Demographics
NPI:1225661796
Name:ROCCO PHARMACY INC
Entity Type:Organization
Organization Name:ROCCO PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/ PIC
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:714-603-7972
Mailing Address - Street 1:1491 E LA PALMA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1564
Mailing Address - Country:US
Mailing Address - Phone:714-603-7972
Mailing Address - Fax:714-603-7992
Practice Address - Street 1:1491 E LA PALMA AVE STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1564
Practice Address - Country:US
Practice Address - Phone:714-603-7972
Practice Address - Fax:714-603-7992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy