Provider Demographics
NPI:1770848566
Name:RESOURCE PHARMACY, INC
Entity Type:Organization
Organization Name:RESOURCE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:YEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-884-5555
Mailing Address - Street 1:1535 S D ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3253
Mailing Address - Country:US
Mailing Address - Phone:909-884-5555
Mailing Address - Fax:909-884-5454
Practice Address - Street 1:1535 S D ST
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3253
Practice Address - Country:US
Practice Address - Phone:909-884-5555
Practice Address - Fax:909-884-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50891333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy