Organization
MEDICINE MADE EASY
Active
Other names
MOMS Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL J. FICHERA (SENIOR VICE PRESIDENT AND TREASURER)
(508) 297-1018
Entity
Organization
Contact information
Practice address
19300 S HAMILTON AVE, SUITE 170 & 180, GARDENA, CA 90248-4400
(310) 972-2999
(310) 972-2995
Mailing address
19300 S HAMILTON AVE, SUITE 170 & 180, GARDENA, CA 90248-4400
(310) 972-2999
(310) 972-2995
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY 50170
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5622661
NCPDP
—
05
—
PHA 50170
—
CA
01
—
PHY 50170
STATE LICENSE
CA
Enumeration date
05/03/2006
Last updated
03/07/2023
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