Provider Demographics
NPI:1558847392
Name:AVENUE HEALTH INC
Entity Type:Organization
Organization Name:AVENUE HEALTH INC
Other - Org Name:AVENUE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-206-2801
Mailing Address - Street 1:10373 TRADEMARK ST STE A
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5862
Mailing Address - Country:US
Mailing Address - Phone:909-206-2801
Mailing Address - Fax:909-206-2891
Practice Address - Street 1:10373 TRADEMARK ST STE A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5862
Practice Address - Country:US
Practice Address - Phone:909-206-2801
Practice Address - Fax:909-206-2891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy