| NPI | 1235130832 |
|---|---|
| Doing Business As | GRAND AVENUE PHARMACIES |
| Entity Type | Organization |
| Authorized Contact | MARGO SOBOL Owner 310-649-3775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY46748) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2017-03-01 |