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NPI Code Detail

MEDICARE: MEDICINE MADE EASY

MEDICARE: MEDICINE MADE EASY
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
13336C0003XCommunity/Retail PharmacyPHY 50169CA
23336S0011XSpecialty PharmacyPHY 50169CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PHY 50169OTHERCASTATE PHARMACY LIC
30508082OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number : 1598723579
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICINE MADE EASY
Provider Business Mailing Address
First Line : 5417 WHITTIER BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-4101
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5417 WHITTIER BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-4101
Country : US
Telephone Number : 323-722-1010
Fax Number : 323-722-8040
Authorized Official
Title or Position : SENIOR VICE PRESIDENT AND TREASURER
Name : RUSSELL J. FICHERA
Credential :
Telephone Number : 508-297-1018
Provider Enumeration Date : 05/01/2006
Last Update Date : 03/07/2023

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Directions to “MEDICINE MADE EASY ” Practice Location

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