Organization
FOOD4LESS OF SOUTHERN CALIFORNIA INC
Active
Other names
FOOD4LESS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA TRUSTER (PHARMACY ECOMMERCE MANAGER)
(513) 387-7113
Entity
Organization
Contact information
Practice address
260 E LAKE MEAD PKWY, HENDERSON, NV 89015-5582
(702) 558-9277
(702) 558-9274
Mailing address
260 E LAKE MEAD PKWY, HENDERSON, NV 89015-5582
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH01774
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002802505
—
NV
01
—
2988042
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/01/2006
Last updated
02/20/2009
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