Organization
RELIANCE FB RX LLC
Active
Other names
RELIANCE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAHMAJI VALIVETI RPH (MEMBER/OWNER)
(818) 837-5999
Entity
Organization
Contact information
Practice address
11333 SEPULVEDA BLVD, SUITE 1200, MISSION HILLS, CA 91345-1116
(818) 837-5999
(818) 837-5920
Mailing address
11333 SEPULVEDA BLVD, SUITE 1200, MISSION HILLS, CA 91345-1116
(818) 837-5999
(818) 837-5920
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY51184
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY51184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-46091
NCPDP PROVIDER
CA
01
—
PHY 51184
BOARD OF PHARMACY LICENSE
CA
Enumeration date
12/17/2012
Last updated
01/22/2013
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