Organization
PRM PHARMACEUTICAL INC
Active
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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