Organization
SPAULDING PHARMACY INC
Active
Other names
SPAULDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER KONOPOV (PRESIDENT/CEO/SECRETARY/DIR)
(323) 656-3663
Entity
Organization
Contact information
Practice address
7722 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-6220
(323) 656-3663
(323) 656-3668
Mailing address
7722 SANTA MONICA BLVD, WEST HOLLYWOOD, CA 90046-6220
(323) 656-3663
(323) 656-3668
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59124
BOARD OF PHARMACY
CA
Enumeration date
08/03/2005
Last updated
10/01/2024
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