Organization
GREYWELL PHARMACY INC
Active
Other names
GREYWELL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL LVOVICH PHARM D (PRESIDENT/CEO)
(818) 306-5500
Entity
Organization
Contact information
Practice address
10672 RIVERSIDE DR, NORTH HOLLYWOOD, CA 91602-2319
(818) 306-5500
(818) 287-0999
Mailing address
10672 RIVERSIDE DR, NORTH HOLLYWOOD, CA 91602-2319
(818) 306-5500
(818) 287-0999
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56-49910
NCPDP PROVIDER NUMBER
CA
01
—
PHY58650
BOARD OF PHARMACY
CA
Enumeration date
12/16/2013
Last updated
06/29/2022
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