Healthcare Provider Details

I. General information

NPI: 1275887697
Provider Name (Legal Business Name): PLANET PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 05/01/2020
Certification Date: 05/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N ROBERTSON BLVD
BEVERLY HILLS CA
90211-2103
US

IV. Provider business mailing address

121 N ROBERTSON BLVD
BEVERLY HILLS CA
90211-2103
US

V. Phone/Fax

Practice location:
  • Phone: 310-657-7707
  • Fax: 310-657-7708
Mailing address:
  • Phone: 310-657-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHAHNAZ FARNAD
Title or Position: PRESIDENT
Credential:
Phone: 310-657-7707