Provider Demographics
NPI:1629545488
Name:NAIR, RITA S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:S
Last Name:NAIR
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 1:3420 CAMINO TASSAJARA
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4680
Mailing Address - Country:US
Mailing Address - Phone:925-736-0262
Mailing Address - Fax:
Practice Address - Street 1:3420 CAMINO TASSAJARA
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4680
Practice Address - Country:US
Practice Address - Phone:925-736-0262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist