| NPI | 1104995059 |
|---|---|
| Doing Business As | FAIRFAX DISCOUNT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BORIS GOROKHOVSKY Mgr 323-937-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY50390) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2016-05-27 |