Provider Demographics
NPI:1144768839
Name:FIRST CHOICE PHARMACY AND SUPPLY
Entity Type:Organization
Organization Name:FIRST CHOICE PHARMACY AND SUPPLY
Other - Org Name:FIRST CHOICE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELPERIN-ROZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-509-1088
Mailing Address - Street 1:6320 LAUREL CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3213
Mailing Address - Country:US
Mailing Address - Phone:818-509-1088
Mailing Address - Fax:818-509-8358
Practice Address - Street 1:6320 LAUREL CANYON BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3213
Practice Address - Country:US
Practice Address - Phone:818-509-1088
Practice Address - Fax:818-509-8358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy