# TRICARE PHARMACY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Pharmacy Service Enterprises Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700044609
- **Authorized official:** MR. MARK HOWARD DEUTSCH (OWNER)
- **Authorized official phone:** (818) 985-1814

## Contact information

- **Practice address:** 13237 SATICOY ST, SUITE 4, NORTH HOLLYWOOD, CA 91605
- **Practice address phone:** (818) 985-1814
- **Mailing address:** 13237 SATICOY ST, SUITE 4, NORTH HOLLYWOOD, CA 91605-3432
- **Mailing address phone:** (818) 985-1814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHY46616 | CA | Yes |

## Other

- **Enumeration date:** 05/28/2008
- **Last updated:** 05/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHA349270 | MEDICAL PROVIDER NUMBER | — |