Organization
ADVANCED RX INC
Active
Other names
ALVARADO DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH KOHAN (CFO)
(310) 922-0272
Entity
Organization
Contact information
Practice address
1107 S ALVARADO ST, STE 103, LOS ANGELES, CA 90006-4184
(213) 387-6702
(231) 387-6703
Mailing address
13351 RIVERSIDE DR STE D, STE 353, SHERMAN OAKS, CA 91423-2542
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY49031
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5630050
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/14/2008
Last updated
05/04/2009
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