Organization
FORTIVA PHARMACY INC
Active
Organization
FORTIVA PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGDY ZOUEN (CEO)
(818) 757-8977
Entity
Organization
Contact information
Practice address
19562 VENTURA BLVD SUITE 226, TARZANA, CA 91356-2917
(818) 757-8977
(818) 757-8979
Mailing address
19562 VENTURA BLVD STE 226, TARZANA, CA 91356-6065
(818) 757-8977
(818) 757-8978
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
55709
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0520874
NCPDP
CA
05
—
1871594473
—
CA
01
—
2134708
PK
—
01
—
55709
STATE BOARD OF PHARMACY PERMIT
CA
Enumeration date
08/03/2005
Last updated
08/17/2026
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