Organization · NPI-2

10th Avenue Pharmacy

Pharmacy · Los Angeles, CA

NPI number1649791633
StatusActive
Last updated in NPPESJun 29, 2017

Details

NPI
1649791633
Entity type
Organization (NPI-2)
Legal business name
10th Avenue Pharmacy
Organization subpart
No
Enumeration date
Jun 29, 2017
Last updated
Jun 29, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
333600000X PharmacyRPH38205CAYes

Practice location

2706 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2747

Phone 323-298-7693 · Fax 323-298-0443

Mailing address

2706 W Martin Luther King Jr Blvd
Los Angeles, CA 90008-2747

Authorized official

Emmanuel C. Acholonu
Director
3232987693

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