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HAN SAM CORP NPI 1689823486


NPI Information

NPI: 1689823486
Provider Name: HAN SAM CORP

Doing Business As: RIVER'S EDGE PHARMACY

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
36919 COOK ST STE 102
PALM DESERT, CA
ZIP 92211
Phone: (760) 340-3248
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HAN SAM CORP is a pharmacy in Palm Desert, CA. The provider is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. HAN SAM CORP NPI is 1689823486. The provider is registered as an organization entity type.
The provider Is Doing Business As River's Edge Pharmacy.

The provider's business location address is:

36919 COOK ST STE 102
PALM DESERT, CA
ZIP 92211-069
Phone: (760) 340-3248
Fax: (760) 340-3258

The provider's authorized official is Hany Benjamin .
The authorized official title is Ceo and has the following contact phone number (760) 340-3248.

The enumeration date for this NPI number is 9/17/2008 and was last updated on 12/21/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyNo
23336C0004XPharmacyCompounding PharmacyNo
33336H0001XPharmacyHome Infusion Therapy PharmacyNo
43336S0011XPharmacySpecialty PharmacyNo
5332B00000XDurable Medical Equipment & Medical SuppliesNo
6333600000XPharmacyPHY49157CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11689823486MEDICAIDCALIFORNIA
22117821OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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