Organization
CHILDREN'S HOSPITAL LOS ANGELES
Active
Other names
Childrens Hospital Los Angeles Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAX SCOTT LIEBERENZ CPA (SR. VP/CFO)
(323) 361-2235
Entity
Organization
Contact information
Practice address
4650 W SUNSET BLVD RM 1503, LOS ANGELES, CA 90027-6062
(323) 361-8839
(323) 361-7135
Mailing address
4650 W SUNSET BLVD RM 1401, MAILBOX NUMBER 44, LOS ANGELES, CA 90027-6062
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336I0012X
Institutional Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659552636
—
CA
01
—
2062400
PK
—
Enumeration date
11/19/2007
Last updated
10/21/2021
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