Healthcare Provider Details

I. General information

NPI: 1467972364
Provider Name (Legal Business Name): MSA PHARMACEUTICAL SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 WOODMAN AVE
ARLETA CA
91331
US

IV. Provider business mailing address

9720 WOODMAN AVE
ARLETA CA
91331-6422
US

V. Phone/Fax

Practice location:
  • Phone: 818-686-0777
  • Fax: 818-686-0778
Mailing address:
  • Phone: 818-686-0777
  • Fax: 818-686-0778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55662
License Number StateCA

VIII. Authorized Official

Name: MRS. AMAL L. FAHMY
Title or Position: PRESIDENT/PIC
Credential:
Phone: 818-686-0777