Fairveola Banks
Pharmacy, Community/Retail Pharmacy in Lynwood, CA. Organization (NPI-2).
NPI number1285621813
StatusActive
Last updated in NPPESFeb 21, 2017
Details
- NPI
- 1285621813
- Entity type
- Organization (NPI-2)
- Legal business name
- Fairveola Banks
- Organization subpart
- No
- Enumeration date
- Sep 29, 2005
- Last updated
- Feb 21, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PHY48607 | CA | Yes |
| 333600000X | Pharmacy | – | – |
Other names
- Intra Rx Drugs Lynwood (Doing Business As)
Practice location
3628 E Imperial HwySte 102
Lynwood, CA 90262-2643
Phone 310-637-2006 · Fax 310-637-2522
Mailing address
3628 E Imperial HwySte 102
Lynwood, CA 90262-2643
Phone 310-637-2006 · Fax 310-637-2522
Authorized official
Bianca Banks
Pharmacy Coordinator
3106372006
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