| NPI | 1548257348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA MADIEVSKY President 818-988-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: CA 50124) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336S0011X Pharmacy Specialty Pharmacy | |
| 333600000X Pharmacy | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2016-06-02 |