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Organization
VENICE FAMILY - STORE 3
Active
Organization
VENICE FAMILY - STORE 3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON NG (PHARMACY DIRECTOR)
(310) 664-7735
Entity
Organization
Contact information
Practice address
4700 INGLEWOOD BLVD STE 102, CULVER CITY, CA 90230-5896
(310) 664-7757
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 664-7756
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166978
PK
—
Enumeration date
10/10/2016
Last updated
09/11/2023
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