Provider Demographics
NPI:1619056660
Name:RP HEALTHCARE INC
Entity Type:Organization
Organization Name:RP HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RPH
Authorized Official - Phone:707-571-5955
Mailing Address - Street 1:2456 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-6425
Mailing Address - Country:US
Mailing Address - Phone:707-571-5955
Mailing Address - Fax:707-571-5951
Practice Address - Street 1:2456 W 3RD ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-6425
Practice Address - Country:US
Practice Address - Phone:707-571-5955
Practice Address - Fax:707-571-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY456233336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4401130001Medicare NSC