Provider Demographics
NPI:1114378619
Name:IDEAL RX LLC
Entity Type:Organization
Organization Name:IDEAL RX LLC
Other - Org Name:SEVILLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFARMEHR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:310-860-9809
Mailing Address - Street 1:6216 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-2913
Mailing Address - Country:US
Mailing Address - Phone:310-860-9809
Mailing Address - Fax:310-860-9683
Practice Address - Street 1:6216 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2913
Practice Address - Country:US
Practice Address - Phone:310-860-9809
Practice Address - Fax:310-860-9683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-26
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY58832OtherBOARD OF PHARMACY