Organization
SIMI VALLEY LTC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAJYA LAKSHMI MEKA (MANAGING MEMBER)
(818) 640-1190
Entity
Organization
Contact information
Practice address
888 E EASY ST STE C, SIMI VALLEY, CA 93065-1812
(805) 285-2849
Mailing address
888 E EASY ST STE C, SIMI VALLEY, CA 93065-1812
(805) 285-2849
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58912
PHARMACY LICENSE
CA
Enumeration date
03/07/2023
Last updated
06/02/2023
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