RX Trader Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

51609 Issued in CA

Legal business name

RX TRADER INC

Doing business as

GlenRock Pharmacy

Practice address

2256 Colorado Blvd
Suites 107 & 108
Eagle Rock, CA 90041-1164

Phone

(323) 551-5906

Fax

(323) 551-5908

NPI assigned

Feb 28, 2007

Last updated

Sep 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Curtis Hague

Title

Owenr

Phone

(323) 551-5906

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• GlenRock Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410393600000",
    "number": "1720116122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2256 COLORADO BLVD",
            "address_2": "SUITES 107 & 108",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411164",
            "telephone_number": "323-551-5906",
            "fax_number": "323-551-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2256 COLORADO BLVD",
            "address_2": "SUITES 107 & 108",
            "city": "EAGLE ROCK",
            "state": "CA",
            "postal_code": "900411164",
            "telephone_number": "323-551-5906",
            "fax_number": "323-551-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RX TRADER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2014-09-11",
        "status": "A",
        "authorized_official_last_name": "HAGUE",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "OWENR",
        "authorized_official_telephone_number": "323-551-5906"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "51609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GlenRock Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Eagle Rock, CA
• Providers in Eagle Rock, 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 Sep 11, 2014; 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.