Provider Demographics
NPI:1174376370
Name:GOLDEN ROSE PHARMACY INC.
Entity type:Organization
Organization Name:GOLDEN ROSE PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PIC
Authorized Official - Prefix:
Authorized Official - First Name:FARIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-339-5826
Mailing Address - Street 1:4070 BASELINE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6489
Mailing Address - Country:US
Mailing Address - Phone:916-572-1155
Mailing Address - Fax:916-403-7198
Practice Address - Street 1:4070 BASELINE RD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-6489
Practice Address - Country:US
Practice Address - Phone:916-572-1155
Practice Address - Fax:916-403-7198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy