Organization
PETRX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB KIBBEE (CEO)
(833) 571-7387
Entity
Organization
Contact information
Practice address
30941 AGOURA RD STE 126B, WESTLAKE VILLAGE, CA 91361-4673
(833) 571-7387
Mailing address
30941 AGOURA RD STE 126B, WESTLAKE VILLAGE, CA 91361-4673
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
About Stedi
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