MEDICARE: PCS DISCOUNT PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy		CA

General Provider Information

NPI Number	:	1386053387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PCS DISCOUNT PHARMACY INC

Provider Business Mailing Address
First Line	:	4027 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4307
Country	:	US
Telephone Number	:	323-735-7001
Fax Number	:	323-735-7008

Provider Business Practice Location Address
First Line	:	4027 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-4307
Country	:	US
Telephone Number	:	323-735-7001
Fax Number	:	323-735-7008

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. ANTHONY ATAVIAN
Credential	:
Telephone Number	:	323-735-7001

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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