Organization
BASSO PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIREZA ALIBANAEI PHARM D. (PRESIDENT)
(818) 347-1645
Entity
Organization
Contact information
Practice address
28880 MICHELLE DR, AGOURA HILLS, CA 91301-2131
(818) 634-4198
(818) 436-0518
Mailing address
PO BOX 2248, AGOURA HILLS, CA 91376-2248
(818) 347-1645
(818) 347-5712
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
10/13/2018
Last updated
12/09/2020
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