MEDICARE: PREMIER CARE RX 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	:	1487062998
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER CARE RX INC

Provider Business Mailing Address
First Line	:	13703 BURBANK BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-5040
Country	:	US
Telephone Number	:	818-376-0333
Fax Number	:	844-272-1447

Provider Business Practice Location Address
First Line	:	13703 BURBANK BLVD
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91401-5040
Country	:	US
Telephone Number	:	818-376-0333
Fax Number	:	844-272-1447

Authorized Official
Title or Position	:	PRESIDENT/TECH
Name	:	MRS. ANAIT DAVTYAN
Credential	:
Telephone Number	:	818-376-0333

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	12/16/2025

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