Organization
CENTURY PICO PHARMACY INC
Active
Organization
CENTURY PICO PHARMACY INC
Active
Other names
CENTURY PICO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BAHRAM SAMOUHA PHD (PHARMACIST IN CHARGE/VP)
(210) 657-6999
Entity
Organization
Contact information
Practice address
8722 W PICO BLVD, LOS ANGELES, CA 90035-2206
(310) 657-6999
(310) 657-7979
Mailing address
8722 W PICO BLVD, LOS ANGELES, CA 90035-2206
(310) 657-6999
(310) 657-7979
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY41037
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1995335
PK
—
05
—
PHA410370
—
CA
Enumeration date
09/12/2006
Last updated
05/23/2014
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