Organization
CAHUENGA BLVD PHARMACY INC
Active
Organization
CAHUENGA BLVD PHARMACY INC
Active
Other names
Cahuenga Blvd Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SOUREN BASMADJIAN (OWNER / PIC)
(818) 980-1445
Entity
Organization
Contact information
Practice address
5503 CAHUENGA BLVD, STE 100, NORTH HOLLYWOOD, CA 91601-2920
(818) 980-1445
(818) 980-1446
Mailing address
5503 CAHUENGA BLVD, STE 100, NORTH HOLLYWOOD, CA 91601-2920
(818) 980-1445
(818) 980-1446
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY55532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167645
PK
—
Enumeration date
02/01/2017
Last updated
04/19/2017
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