Healthcare Provider Details

I. General information

NPI: 1184473308
Provider Name (Legal Business Name): TOP SHELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S BEVERLY DR STE 301
BEVERLY HILLS CA
90212-4806
US

IV. Provider business mailing address

300 S BEVERLY DR STE 301
BEVERLY HILLS CA
90212-4806
US

V. Phone/Fax

Practice location:
  • Phone: 310-994-6415
  • Fax:
Mailing address:
  • Phone: 310-994-6415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. KATSIARYNA NAVITSKAYA
Title or Position: CEO
Credential:
Phone: 310-994-6415