Provider Demographics
NPI:1417367061
Name:RPHH LLC
Entity Type:Organization
Organization Name:RPHH LLC
Other - Org Name:WELLCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:RKEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-800-7856
Mailing Address - Street 1:1728 W GLENDALE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-8860
Mailing Address - Country:US
Mailing Address - Phone:602-800-7855
Mailing Address - Fax:602-344-9098
Practice Address - Street 1:1728 W GLENDALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-8862
Practice Address - Country:US
Practice Address - Phone:602-800-7855
Practice Address - Fax:602-344-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AZY0058863336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145589OtherPK