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