Organization
PHARMATEK PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHVASH KOHANBASH (PRESIDENT)
(310) 553-6462
Entity
Organization
Contact information
Practice address
10995 N 99TH AVE, SUITE 112, PEORIA, AZ 85345-5405
(928) 583-4781
(877) 513-0770
Mailing address
1529 REXFORD DR, LOS ANGELES, CA 90035-3109
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
Y005901
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y005901
PHARMACY LICENSE
AZ
Enumeration date
04/15/2014
Last updated
04/21/2014
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