Organization
JEEVA LLC
Active
Other names
Pacific Grand Pharmacy and Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVINASH GOVIND GHANEKAR RPH (MANAGER)
(818) 500-2517
Entity
Organization
Contact information
Practice address
501 W GLENOAKS BLVD STE 12, GLENDALE, CA 91202-4041
(818) 500-1517
(818) 500-1519
Mailing address
501 W GLENOAKS BLVD, SUITE#12, GLENDALE, CA 91202-2896
(818) 500-1517
(818) 500-1519
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY51730
CA
Other
Enumeration date
01/24/2014
Last updated
10/23/2015
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