Provider Demographics
NPI:1265589311
Name:F & R PHARMACY INC
Entity type:Organization
Organization Name:F & R PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHRM AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAIBORZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MOROVATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-348-0524
Mailing Address - Street 1:21773 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1835
Mailing Address - Country:US
Mailing Address - Phone:818-348-0524
Mailing Address - Fax:818-348-2405
Practice Address - Street 1:21773 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1835
Practice Address - Country:US
Practice Address - Phone:818-348-0524
Practice Address - Fax:818-348-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY393293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA393290Medicaid
0539075OtherNCPDP PROVIDER IDENTIFICATION NUMBER