Provider Demographics
NPI:1598723579
Name:MEDICINE MADE EASY
Entity Type:Organization
Organization Name:MEDICINE MADE EASY
Other - Org Name:WHITTIER GOODRICH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT AND TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FICHERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-297-1018
Mailing Address - Street 1:5417 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-4101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5417 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-4101
Practice Address - Country:US
Practice Address - Phone:323-722-1010
Practice Address - Fax:323-722-8040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 501693336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA 50169Medicaid
CAPHY 50169OtherSTATE PHARMACY LIC
0508082OtherOTHER ID NUMBER-COMMERCIAL NUMBER
FW2036348OtherDEA