Organization
LAX PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL AHDOUT PHARMD (PRESIDENT)
(310) 674-1403
Entity
Organization
Contact information
Practice address
4457 LENNOX BLVD, LENNOX, CA 90304-2303
(310) 674-1403
(310) 674-1421
Mailing address
4457 LENNOX BLVD, LENNOX, CA 90304-2303
(310) 674-1403
(310) 674-1421
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY48895
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0594730
NCPDP
CA
05
—
1255422085
—
CA
Enumeration date
09/27/2006
Last updated
07/18/2013
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