Provider Demographics
NPI:1194730721
Name:CFHS HOLDINGS, INC.
Entity type:Organization
Organization Name:CFHS HOLDINGS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:DONITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-745-2333
Mailing Address - Street 1:PO BOX 261455
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91426-1455
Mailing Address - Country:US
Mailing Address - Phone:213-745-2333
Mailing Address - Fax:213-745-2324
Practice Address - Street 1:777 E 15TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-2121
Practice Address - Country:US
Practice Address - Phone:213-745-2333
Practice Address - Fax:213-745-2324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY47361333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA473610Medicaid
0510734OtherOTHER ID NUMBER-COMMERCIAL NUMBER