Organization
OLIVE BRANCH PHARMACY
Active
Other names
OLIVE BRANCH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
REDDA ALHOUSSAYNI PHARM.D. (OWNER)
(323) 432-2131
Entity
Organization
Contact information
Practice address
2811 S SAN PEDRO ST, LOS ANGELES, CA 90011-2023
(323) 432-2131
(323) 432-2012
Mailing address
2070 S CENTRAL AVE, LOS ANGELES, CA 90011-1235
(213) 536-4888
(213) 536-4889
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY53627
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155055
PK
—
Enumeration date
11/20/2015
Last updated
02/22/2017
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