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Organization

FOX HILLS PHARMACY INC

Active
Other names
GRAND AVENUE PHARMACIES
Organization subpart
No

Provider details

NPI number
Authorized official
MARGO SOBOL PHARM D (OWNER)
(310) 649-3775
Entity
Organization

Contact information

Practice address
4455 W 117TH ST, STE 101, HAWTHORNE, CA 90250-2241
(310) 649-3774
(310) 649-3720
Mailing address
4455 W 117TH ST, STE 101, HAWTHORNE, CA 90250-2241
(310) 649-3774
(310) 649-3720

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHY46748
CA
3336H0001X
Home Infusion Therapy Pharmacy
3336M0003X
Managed Care Organization Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2001007
PK
05
PHA467480
CA
Enumeration date
08/03/2005
Last updated
03/01/2017
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