FMP Enterprises, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY 46616 Issued in CA

Legal business name

FMP ENTERPRISES, LLC

Doing business as

Tricare Pharmacy

Practice address

13237 Saticoy St
#4
North Hollywood, CA 91605-3432

Phone

(818) 985-1814

Fax

(818) 985-5005

NPI assigned

Jul 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Howard Deutsch

Title

Member

Phone

(818) 985-1814

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tricare Pharmacy Doing business as

Tax ID family

Farmers Market Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• FMP Enterprises LLC

  • Pharmacy
  • North Hollywood, CA
  • NPI 1730368317
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1245469295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 LAUREL CANYON BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916072711",
            "telephone_number": "818-985-1814",
            "fax_number": "818-985-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13237 SATICOY ST",
            "address_2": "#4",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916053432",
            "telephone_number": "818-985-1814",
            "fax_number": "818-985-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMP ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "818-985-1814",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY 46616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA466160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tricare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Flores, M.A.
• Melizza Ahide Flores, ASW 118508
• Rosemary Katherine Flores, LMFT
• Trinidad Flores, RN
• FMP Enterprises LLC
• Julia A Fonseca
• Laura Fonseca, MT-BC
• Nathalia Fonseca, RN
• Ninotschka Fonseca
• Foot and Wound Care Center

• Long Term Care Pharmacy in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.