Organization
APOTHECARY SHOP OF LOS ANGELES INC
Active
Organization
APOTHECARY SHOP OF LOS ANGELES INC
Active
Parent organization
APOTHECARY HOLDINGS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
APOTHECARY HOLDINGS INC
Authorized official
JOHN D MUSIL PHARMD, RPH (DIRECTOR/CEO)
(623) 434-3657
Entity
Organization
Contact information
Practice address
325 N LARCHMONT BLVD, LOS ANGELES, CA 90004-3011
(323) 466-1414
(323) 466-1333
Mailing address
1606 W WHISPERING WIND DR, PHOENIX, AZ 85085-0678
(623) 434-3659
(623) 434-3673
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 49836
CA
3336C0004X
Compounding Pharmacy
PHY 49836
CA
3336S0011X
Specialty Pharmacy
PHY 49836
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0519263
OTHER ID NUMBER-COMMERCIAL NUMBER
—
01
—
CN874A
MEDICARE PART B MASS IMMUNIZATION ROSTER BILLER
—
05
—
PHA165980
—
CA
Enumeration date
11/08/2006
Last updated
03/23/2010
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