Provider Demographics
NPI:1346937216
Name:FOX, MARTHA (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2207
Mailing Address - Country:US
Mailing Address - Phone:562-423-0036
Mailing Address - Fax:562-428-7310
Practice Address - Street 1:4402 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2207
Practice Address - Country:US
Practice Address - Phone:562-423-0036
Practice Address - Fax:562-428-7310
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16205183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician