Healthcare Provider Details

I. General information

NPI: 1447462908
Provider Name (Legal Business Name): FVS HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 GARFIELD AVE
COMMERCE CA
90040-3102
US

IV. Provider business mailing address

3328 GARFIELD AVE
COMMERCE CA
90040-3102
US

V. Phone/Fax

Practice location:
  • Phone: 323-201-4488
  • Fax: 866-728-4810
Mailing address:
  • Phone: 323-201-4488
  • Fax: 866-728-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number50160
License Number StateCA

VIII. Authorized Official

Name: AMANDA WILLIAMS
Title or Position: ADMINISTRATION ASSISTANT
Credential:
Phone: 702-564-2079