Organization
PRM PHARMACEUTICAL INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMOND NIKRAVESH RPH (OWNER PHARMACIST)
(310) 837-1030
Entity
Organization
Contact information
Practice address
11126 PALMS BLVD, LOS ANGELES, CA 90034-6503
(310) 837-1030
(310) 837-9946
Mailing address
11126 PALMS BLVD, LOS ANGELES, CA 90034-6503
(310) 837-1030
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 44725
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0541727
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA395140
—
CA
Enumeration date
08/20/2006
Last updated
03/07/2023
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