Provider Demographics
NPI:1366571275
Name:HRH PHARMACY INC
Entity type:Organization
Organization Name:HRH PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-838-0511
Mailing Address - Street 1:1900 MCHENRY AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ESCALON
Mailing Address - State:CA
Mailing Address - Zip Code:95320-9473
Mailing Address - Country:US
Mailing Address - Phone:209-838-0511
Mailing Address - Fax:209-838-0611
Practice Address - Street 1:1900 MCHENRY AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ESCALON
Practice Address - State:CA
Practice Address - Zip Code:95320-9473
Practice Address - Country:US
Practice Address - Phone:209-838-0511
Practice Address - Fax:209-838-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY508173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1997390OtherPK
CAPHA46034Medicaid