Organization
NEXGEN PHARMACY INC
Active
Organization
NEXGEN PHARMACY INC
Active
Other names
Infinity Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAPOOR RAHIMI (PRESIDENT/CEO/OWNER)
(310) 919-4100
Entity
Organization
Contact information
Practice address
10738 JEFFERSON BLVD, STE E BLDG 3, CULVER CITY, CA 90230-4933
(310) 919-4100
(310) 919-4102
Mailing address
10738 JEFFERSON BLVD, STE E BLDG 3, CULVER CITY, CA 90230-4933
(310) 919-4100
(310) 919-4102
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176391
PK
—
Enumeration date
03/06/2018
Last updated
04/25/2019
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