Provider Demographics
NPI:1568234532
Name:ALBERT, RITA RIAD (RPH)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:RIAD
Last Name:ALBERT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:RIAD
Other - Last Name:ALBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15454 BUCHANAN LN
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-5365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16854 IVY AVE STE C
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-1504
Practice Address - Country:US
Practice Address - Phone:909-321-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist