| NPI | 1629616784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER JOHNSON Manager 818-294-2657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| 3336H0001X Pharmacy Home Infusion Therapy Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2020-07-24 |