| NPI | 1184313355 |
|---|---|
| Doing Business As | FOREVER YOUNG RX |
| Doing Business As | FOREVER YOUNG PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DANE DAVID FREDERICKSEN Owner 714-757-7584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy, Mail Order Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2023-05-03 |
| Last Update Date | 2023-05-03 |