MEDICARE: FTF PHARMACY CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	54296	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2158902	OTHER		PK

General Provider Information

NPI Number	:	1083973259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FTF PHARMACY CORPORATION

Provider Business Mailing Address
First Line	:	17742 BEACH BLVD STE 100
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6847
Country	:	US
Telephone Number	:	714-848-4447
Fax Number	:	714-843-9149

Provider Business Practice Location Address
First Line	:	17742 BEACH BLVD STE 100
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-6847
Country	:	US
Telephone Number	:	714-848-4447
Fax Number	:	714-843-9149

Authorized Official
Title or Position	:	OWNER, PIC
Name	:	YOON CHANG
Credential	:
Telephone Number	:	714-848-4447

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	01/24/2017

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Directions to “FTF PHARMACY CORPORATION ” Practice Location

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