Organization
HEALING COMPOUNDS INC
Active
Other names
MICHAEL'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABAK R. KOHANTEB PHARM D (PRESIDENT / PHARMACIST IN CHARGE)
(818) 905-0669
Entity
Organization
Contact information
Practice address
4955 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-1801
(818) 905-0669
(818) 905-0016
Mailing address
4955 VAN NUYS BLVD, SHERMAN OAKS, CA 91403-1801
(818) 905-0669
(818) 905-0016
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY43586
CA
3336L0003X
Long Term Care Pharmacy
PHY43586
CA
3336S0011X
Specialty Pharmacy
PHY43586
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY43586
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
11/02/2016
Last updated
11/02/2016
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