Organization
BASSO PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIREZA ALIBANAEI PHARM. D. (PRESIDENT)
(805) 242-4575
Entity
Organization
Contact information
Practice address
28880 MICHELLE DR, AGOURA HILLS, CA 91301-2131
(818) 634-4198
Mailing address
PO BOX 2248, AGOURA HILLS, CA 91376-2248
(818) 634-4198
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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