Organization
AVG INC
Active
Other names
AdvanceCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN DAVID SCHUKRAFT (CEO/CFO/SEC/DIR)
(818) 231-0751
Entity
Organization
Contact information
Practice address
8700 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4508
(323) 475-1475
Mailing address
8700 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90069-4508
(323) 475-1475
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
07/09/2006
Last updated
07/05/2022
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