Provider Demographics
NPI:1730416884
Name:FOX DRUG OF TORRANCE, INC.
Entity type:Organization
Organization Name:FOX DRUG OF TORRANCE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ATALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-377-4871
Mailing Address - Street 1:905 DEEP VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274
Mailing Address - Country:US
Mailing Address - Phone:310-377-4871
Mailing Address - Fax:310-377-8261
Practice Address - Street 1:905 DEEP VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274
Practice Address - Country:US
Practice Address - Phone:310-377-4871
Practice Address - Fax:310-377-8261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 160073336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-10215OtherNCPDP
CAPHY 16007OtherBOARD OF PHARMACY PERMIT