Organization
FISHBOR INC
Active
Organization
FISHBOR INC
Active
Other names
PLAZA WEST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA KILIMNIK PHARM D (PRESIDENT/PIC)
(818) 894-3333
Entity
Organization
Contact information
Practice address
8704 SEPULVEDA BLVD, NORTH HILLS, CA 91343-5112
(818) 894-3333
(818) 894-3301
Mailing address
8704 SEPULVEDA BLVD, NORTH HILLS, CA 91343-5112
(818) 894-3333
(818) 894-3301
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY49969
CA
3336L0003X
Long Term Care Pharmacy
PHY 49969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0593411
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/19/2006
Last updated
03/16/2016
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