Healthcare Provider Details

I. General information

NPI: 1093115446
Provider Name (Legal Business Name): 1ST CHOICE PHARMACY MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6755 MIRA MESA BLVD STE 124
SAN DIEGO CA
92121-4311
US

IV. Provider business mailing address

788 MORRIS TPKE FL 3
SHORT HILLS NJ
07078-2637
US

V. Phone/Fax

Practice location:
  • Phone: 858-218-3180
  • Fax: 858-218-3185
Mailing address:
  • Phone: 973-869-2820
  • Fax: 973-869-2822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55868
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANUSH AMIN
Title or Position: PRESIDENT
Credential:
Phone: 858-218-3180