Organization
PRIME LIBERTY PHARMACY INC
Active
Organization
PRIME LIBERTY PHARMACY INC
Active
Other names
PRIME LIBERTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HASMIK GEVSHENIAN (CEO/CFO/SEC/DIR)
(818) 465-3515
Entity
Organization
Contact information
Practice address
7335 VAN NUYS BLVD STE 107, VAN NUYS, CA 91405-1951
(818) 465-3515
(818) 465-3514
Mailing address
7335 VAN NUYS BLVD STE 107, VAN NUYS, CA 91405-1951
(818) 465-3515
(818) 465-3514
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Enumeration date
03/07/2019
Last updated
07/15/2021
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