Organization
MEDTOWN RX INC
Active
Organization
MEDTOWN RX INC
Active
Other names
MEDTOWN RX INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HOWARD RAPPAPORT (PRESIDENT/OWNER)
(818) 500-0079
Entity
Organization
Contact information
Practice address
4128 W BURBANK BLVD, BURBANK, CA 91505
(818) 500-0079
(818) 500-0225
Mailing address
4128 W BURBANK BLVD, BURBANK, CA 91505
(818) 500-0079
(818) 500-0225
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY55464
CA
3336C0004X
Compounding Pharmacy
PHY55464
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-49895
NCPDP PROVIDER
—
01
—
PHY 55464
BOARD OF PHARMACY PERMIT
CA
Enumeration date
12/10/2013
Last updated
01/09/2017
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