MEDICARE: SAFE PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336M0002X	Mail Order Pharmacy

General Provider Information

NPI Number	:	1477109981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE PHARMACY

Provider Business Mailing Address
First Line	:	925 N LA BREA AVE FL 4
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90038-2321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 CAMERON ST STE 102
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2249
Country	:	US
Telephone Number	:	702-384-0078
Fax Number	:

Authorized Official
Title or Position	:	CONSULTANT
Name	:	KATY MORTON
Credential	:
Telephone Number	:	505-227-1517

Provider Enumeration Date	:	08/12/2019
Last Update Date	:	08/12/2019

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Directions to “SAFE PHARMACY ” Practice Location

Language	Start Address	Practice Location

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