MEDICARE: MILART PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PHY47582	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2003169	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083728059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILART PHARMACY INC

Provider Business Mailing Address
First Line	:	300 S BEVERLY DR
Second Line	:	STE 100
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4808
Country	:	US
Telephone Number	:	310-553-0225
Fax Number	:	310-553-8454

Provider Business Practice Location Address
First Line	:	300 S BEVERLY DR
Second Line	:	STE 100
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-4808
Country	:	US
Telephone Number	:	310-553-0225
Fax Number	:	310-553-8454

Authorized Official
Title or Position	:	OWNER
Name	:	ARASH LEVIAN
Credential	:	PHARM.D.
Telephone Number	:	310-553-0225

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/25/2022

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Directions to “MILART PHARMACY INC ” Practice Location

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