Organization
SHORELINE PHARMACEUTICALS INC
Active
Other names
Shoreline Pharmaceuticals, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW WALK (PRESIDENT)
(310) 464-9170
Entity
Organization
Contact information
Practice address
16530 VENTURA BLVD STE 610, ENCINO, CA 91436-5042
(310) 464-9170
(310) 464-9171
Mailing address
18375 VENTURA BLVD STE 501, TARZANA, CA 91356-4218
(310) 464-9170
(310) 464-9171
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PHY51832
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136134
PK
—
Enumeration date
04/26/2012
Last updated
09/30/2014
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