Healthcare Provider Details

I. General information

NPI: 1518876861
Provider Name (Legal Business Name): SHALOM RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18000 VENTURA BLVD STE 2
ENCINO CA
91316-3533
US

IV. Provider business mailing address

18000 VENTURA BLVD STE 2
ENCINO CA
91316-3533
US

V. Phone/Fax

Practice location:
  • Phone: 818-774-1800
  • Fax: 818-774-1188
Mailing address:
  • Phone: 818-774-1800
  • Fax: 818-774-1188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BABAK KOHANCHI
Title or Position: PRESIDENT/CEO
Credential: PHARM D
Phone: 818-774-1800