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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