Tricare Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY46616 Issued in CA

Legal business name

TRICARE PHARMACY

Practice address

13237 Saticoy St
Suite 4
North Hollywood, CA 91605

Phone

(818) 985-1814

NPI assigned

May 28, 2008

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

Owner

Phone

(818) 985-1814

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pharmacy Service Enterprises Inc Other name

Locations

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1700044609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13237 SATICOY ST",
            "address_2": "SUITE 4",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916053432",
            "telephone_number": "818-985-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13237 SATICOY ST",
            "address_2": "SUITE 4",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "91605",
            "telephone_number": "818-985-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "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": "PHY46616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "PHA349270",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacy Service Enterprises Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• 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 May 28, 2008; 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.