Organization
MIRACLE CARE INC
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR KARAGEZYAN (OWNER)
(818) 996-2878
Entity
Organization
Contact information
Practice address
19225 VENTURA BLVD, TARZANA, CA 91356-3122
(818) 996-2878
(818) 996-2877
Mailing address
19225 VENTURA BLVD, TARZANA, CA 91356-3122
(818) 996-2878
(818) 996-2877
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY51652
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY51652
CA
3336L0003X
Long Term Care Pharmacy
PHY51652
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-64624
NCPDP NUMBER
CA
05
—
2029339
—
CA
01
—
2122599
PK
—
01
—
PHY51652
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
07/30/2006
Last updated
04/30/2018
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