Organization
RX INGREDIENTS INC
Active
Other names
RX INGREDIENTS INC
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA AZRILYAN (PRESIDENT/CEO)
(818) 849-5611
Entity
Organization
Contact information
Practice address
7107 VALJEAN AVE, VAN NUYS, CA 91406-3917
(818) 849-5611
(818) 646-0308
Mailing address
7107 VALJEAN AVE, VAN NUYS, CA 91406-3917
(818) 849-5611
(818) 646-0308
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY48315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457422479
—
CA
01
—
2111954
PK
—
Enumeration date
11/13/2006
Last updated
12/18/2016
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