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Organization

PACOIMA RX PHARMACY INC

Active
Other names
PACOIMA RX PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
MAYER RAFIKALIMY (PRESIDENT/CEO)
(747) 227-3077
Entity
Organization

Contact information

Practice address
13630 VAN NUYS BLVD STE 101, PACOIMA, CA 91331-3655
(747) 227-3077
(747) 227-3078
Mailing address
13630 VAN NUYS BLVD STE 101, PACOIMA, CA 91331-3655
(747) 227-3077
(747) 227-3078

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHY58755
BOARD OF PHARMACY
CA
Enumeration date
08/29/2022
Last updated
08/29/2022
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