Organization
LIFELINE RX INC
Active
Other names
LIFELINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
POLINA OGANESYAN (PRESIDENT/CEO)
(800) 920-5030
Entity
Organization
Contact information
Practice address
6005 VINELAND AVE STE 102, NORTH HOLLYWOOD, CA 91606-4985
(800) 920-5030
(818) 210-0098
Mailing address
6005 VINELAND AVE STE 102, NORTH HOLLYWOOD, CA 91606-4985
(800) 920-5030
(818) 210-0098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59549
BOARD OF PHARMACY
CA
Enumeration date
08/09/2024
Last updated
08/09/2024
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