Provider Demographics
NPI:1578900627
Name:GADE LLC
Entity Type:Organization
Organization Name:GADE LLC
Other - Org Name:CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:
Authorized Official - Last Name:GADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-367-7677
Mailing Address - Street 1:129 N MCKINLEY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-6593
Mailing Address - Country:US
Mailing Address - Phone:951-268-9644
Mailing Address - Fax:
Practice Address - Street 1:129 N MCKINLEY ST STE 102
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-6593
Practice Address - Country:US
Practice Address - Phone:951-268-9644
Practice Address - Fax:951-616-3972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY514573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578900627Medicaid
CA1578900627Medicaid