Organization
CURERX COMPOUNDING PHARMACY INC
Active
Other names
CURERX
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP ETTEDGUI PHARM.D. (PRESIDENT/PIC)
(818) 881-2998
Entity
Organization
Contact information
Practice address
18625 SHERMAN WAY, SUITE 107, RESEDA, CA 91335-4148
(818) 881-2998
(818) 881-2996
Mailing address
5060 W SUNSET BLVD, LOS ANGELES, CA 90027-5840
(323) 667-1111
(323) 667-1131
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53473
CA
3336C0004X
Compounding Pharmacy
PHY 53473
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5652424
NCPDP PROVIDER ID
CA
01
—
PHY 53473
STATE BOARD OF PHARMACY
CA
Enumeration date
08/01/2014
Last updated
10/27/2015
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