Provider Demographics
NPI:1427597988
Name:GREENE, MALINDA CLAUDINE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MALINDA
Middle Name:CLAUDINE
Last Name:GREENE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14305 MERIDIAN PKWY
Mailing Address - Street 2:FL 1
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92518-3034
Mailing Address - Country:US
Mailing Address - Phone:951-251-7520
Mailing Address - Fax:951-251-7502
Practice Address - Street 1:14305 MERIDIAN PKWY
Practice Address - Street 2:FL 1
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92518-3034
Practice Address - Country:US
Practice Address - Phone:951-251-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist