Provider Demographics
NPI:1003101999
Name:STUDIORX INC
Entity Type:Organization
Organization Name:STUDIORX INC
Other - Org Name:STUDIORX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:EIDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-934-8000
Mailing Address - Street 1:937 CRENSHAW BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1938
Mailing Address - Country:US
Mailing Address - Phone:323-934-8000
Mailing Address - Fax:323-934-8001
Practice Address - Street 1:937 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1938
Practice Address - Country:US
Practice Address - Phone:323-934-8000
Practice Address - Fax:323-934-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-19
Last Update Date:2011-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY50635333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY50635OtherCALIFORNIA STATE BOARD OF PHARMACY