Provider Demographics
NPI:1699830034
Name:BOSS, ROSEMARY (RPH)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:BOSS
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 1:2101 VALE RD
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3835
Mailing Address - Country:US
Mailing Address - Phone:510-235-4443
Mailing Address - Fax:510-235-5527
Practice Address - Street 1:2101 VALE RD
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3835
Practice Address - Country:US
Practice Address - Phone:510-235-4443
Practice Address - Fax:510-235-5527
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist