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General NPI Number Information
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NPI Number | 1598723579
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Entity Type | Organization
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Legal Business Name | MEDICINE MADE EASY
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5417 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4101
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Country | US
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Telephone | 323-722-1010
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Fax | 323-722-8040
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Provider Business Mailing Address
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Address Line | 5417 WHITTIER BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-4101
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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 | SENIOR VICE PRESIDENT AND TREASURER
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Name | RUSSELL J. FICHERA
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Credential |
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Telephone | 508-297-1018
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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 | PHY 50169
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PHY 50169
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License Number State | CA
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