Organization
BODYSTORE INC
Active
Other names
HOSPICARE PHARMACY LOS ANGELES
Organization subpart
No
Provider details
NPI number
Authorized official
JENSEN CHANG PHARM.D. (CEO)
(818) 736-5828
Entity
Organization
Contact information
Practice address
3000 N HOLLYWOOD WAY STE 103, BURBANK, CA 91505-1026
(818) 736-5828
(818) 736-5838
Mailing address
PO BOX 370, SAN DIMAS, CA 91773-0370
(818) 736-5828
(818) 736-5838
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997864
PK
—
05
—
PHA46900
—
CA
Enumeration date
08/10/2006
Last updated
05/23/2019
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