Healthcare Provider Details

I. General information

NPI: 1063730141
Provider Name (Legal Business Name): E R PHARMACY RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19500 PLUMMER ST UNIT D3
NORTHRIDGE CA
91324-2153
US

IV. Provider business mailing address

19500 PLUMMER ST UNIT D3
NORTHRIDGE CA
91324-2153
US

V. Phone/Fax

Practice location:
  • Phone: 818-341-1150
  • Fax: 818-341-1155
Mailing address:
  • Phone: 818-341-1150
  • Fax: 818-341-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number50257
License Number StateCA

VIII. Authorized Official

Name: NANCY SIMONIAN
Title or Position: PRESIDENT
Credential:
Phone: 818-341-1150