Organization
CHURCH CAPITAL LLC
Active
Other names
MEDICINE LAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARMEN MANOUKIAN RPH (MEMBER/PIC)
(818) 997-7000
Entity
Organization
Contact information
Practice address
7400 VAN NUYS BLVD, UNIT 101, VAN NUYS, CA 91405-1966
(818) 997-7000
(818) 997-7003
Mailing address
7400 VAN NUYS BLVD, UNIT 101, VAN NUYS, CA 91405-1966
(818) 997-7000
(818) 997-7003
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY51231
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY 51231
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-67199
NCPDP
CA
01
—
1295812345
MEDI-CAL PROVIDER NUMNER
CA
01
—
PHY51231
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
11/01/2006
Last updated
03/26/2013
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