Provider Demographics
NPI:1063730141
Name:E R PHARMACY RX INC
Entity type:Organization
Organization Name:E R PHARMACY RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-341-1150
Mailing Address - Street 1:19500 PLUMMER ST UNIT D3
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2153
Mailing Address - Country:US
Mailing Address - Phone:818-341-1150
Mailing Address - Fax:818-341-1155
Practice Address - Street 1:19500 PLUMMER ST UNIT D3
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2153
Practice Address - Country:US
Practice Address - Phone:818-341-1150
Practice Address - Fax:818-341-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X
CA502573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124982OtherPK
CA6550520001OtherPTAN