Healthcare Provider Details

I. General information

NPI: 1487062998
Provider Name (Legal Business Name): PREMIER CARE RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13703 BURBANK BLVD
VAN NUYS CA
91401-5040
US

IV. Provider business mailing address

13703 BURBANK BLVD
VAN NUYS CA
91401-5040
US

V. Phone/Fax

Practice location:
  • Phone: 818-376-0333
  • Fax: 844-272-1447
Mailing address:
  • Phone: 818-376-0333
  • Fax: 844-272-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. ANAIT DAVTYAN
Title or Position: PRESIDENT/TECH
Credential:
Phone: 818-376-0333