MEDICARE: FARMACIA REMEDIOS 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	PHY48730	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5628233	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1730376559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMACIA REMEDIOS INC

Provider Business Mailing Address
First Line	:	PO BOX 9830
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-9830
Country	:	US
Telephone Number	:	877-540-4748
Fax Number	:	801-716-4872

Provider Business Practice Location Address
First Line	:	4916 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-3115
Country	:	US
Telephone Number	:	323-266-8800
Fax Number	:	323-266-0800

Authorized Official
Title or Position	:	COO
Name	:	BEN SINGER
Credential	:
Telephone Number	:	415-377-5525

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	10/14/2010

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Directions to “FARMACIA REMEDIOS INC ” Practice Location

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