Organization
MY FIRST PHARMACY CORPORATION
Active
Other names
DOC ARVIDSONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUAINE R ARVIDSON MBA (PRESIDENT)
(951) 207-3315
Entity
Organization
Contact information
Practice address
1820 FULLERTON AVE, STE 145, CORONA, CA 92881-3160
(951) 272-6000
(951) 272-6322
Mailing address
PO BOX 7144, HUNTINGTON BEACH, CA 92615-7144
(951) 207-3315
(951) 272-6322
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY47467
CA
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5618256
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PH474670
—
CA
Enumeration date
06/24/2006
Last updated
06/10/2011
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