Organization
FRED P STARTZ
Active
Other names
MARVINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
FRED STARTZ (OWNER)
(310) 278-7734
Entity
Organization
Contact information
Practice address
8933 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4912
(310) 278-7734
(310) 278-7748
Mailing address
8933 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4912
(310) 278-7734
(310) 278-7748
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0598358
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA43336
—
CA
Enumeration date
07/30/2006
Last updated
12/29/2011
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