Rivendell Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY45422 Issued in CA

Legal business name

RIVENDELL INC.

Practice address

11721 Telegraph Rd
Suite I
Santa Fe Springs, CA 90670-3674

Phone

(562) 949-1003

NPI assigned

May 15, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Thomas Jackson Roberson, RPH

Title

Pharmacist in Charge

Phone

(562) 949-1003

Specialties & licenses 1

Addresses

Other names 1

• griffith drug Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487860771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "address_2": "SUITE I",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 TELEGRAPH RD",
            "address_2": "SUITE I",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703674",
            "telephone_number": "562-949-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVENDELL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "562-949-1003",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY45422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "griffith drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria Rios
• Stacy Rios
• Stephanie Rios
• Susy Rios
• Lucia Riva, PHARMD
• Angie Gaudeth Rivera
• Irma Rivera
• Joe Roy Rivera, DC
• Thomas J Roberson, RPH
• Kieyonna Roberts

• Community/Retail Pharmacy in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.