Organization
GRANCELL VILLAGE OF THE LOS ANGELES
Active
Other names
JOYCE EISENBURG KEEFER MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BOB SHMAEFF MPA (DIRECTOR OF PHARMACY SERVICES)
(818) 654-5521
Entity
Organization
Contact information
Practice address
7150 TAMPA AVE, 1ST FLOOR, RESEDA, CA 91335
(818) 758-5017
(818) 774-2430
Mailing address
7150 TAMPA AVE, 1ST FLOOR, RESEDA, CA 91335-3700
(818) 758-5017
(818) 774-2430
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
MSP48566
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2113017
PK
—
Enumeration date
01/02/2008
Last updated
05/25/2018
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