Provider Demographics
NPI:1972592830
Name:ROSAMOND PHARMACY
Entity Type:Organization
Organization Name:ROSAMOND PHARMACY
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELSAYED
Authorized Official - Middle Name:BA
Authorized Official - Last Name:HAMOUDA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:661-722-3888
Mailing Address - Street 1:1415 W ROSAMOND BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSAMOND
Mailing Address - State:CA
Mailing Address - Zip Code:93560-7429
Mailing Address - Country:US
Mailing Address - Phone:661-256-1118
Mailing Address - Fax:661-256-1119
Practice Address - Street 1:1415 W ROSAMOND BLVD
Practice Address - Street 2:
Practice Address - City:ROSAMOND
Practice Address - State:CA
Practice Address - Zip Code:93560-7429
Practice Address - Country:US
Practice Address - Phone:661-256-1118
Practice Address - Fax:661-256-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46967333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy