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General NPI Number Information
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NPI Number | 1366554347
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Entity Type | Organization
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Legal Business Name | METRO DISCOUNT PHARMACY
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1930 WILSHIRE BLVD STE 1934
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City | LOS ANGELES
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State | CA
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Zip | 90057-3605
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Country | US
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Telephone | 213-484-0994
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Fax | 213-484-4116
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Provider Business Mailing Address
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Address Line | 1930 WILSHIRE BLVD STE 1934
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City | LOS ANGELES
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State | CA
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Zip | 90057-3605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAREK EBRAHIM
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Credential |
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Telephone | 818-395-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY44769
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License Number State | CA
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