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General NPI Number Information
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NPI Number | 1215963913
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Entity Type | Organization
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Legal Business Name | MY FIRST PHARMACY CORPORATION
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 1820 FULLERTON AVE STE 145
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City | CORONA
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State | CA
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Zip | 92881-3160
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Country | US
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Telephone | 951-272-6000
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Fax | 951-272-6322
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Provider Business Mailing Address
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Address Line | PO BOX 7144
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92615-7144
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Country | US
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Telephone | 951-207-3315
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Fax | 951-272-6322
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DUAINE R ARVIDSON
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Credential | MBA
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Telephone | 951-207-3315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY47467
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License Number State | CA
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