Healthcare Provider Details

I. General information

NPI: 1124643168
Provider Name (Legal Business Name): OP PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 10/01/2020
Certification Date: 10/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16700 VALLEY VIEW AVE STE 280
LA MIRADA CA
90638-5829
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY STE 400
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 323-593-7396
  • Fax:
Mailing address:
  • Phone: 25-627-7100
  • Fax: 855-217-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALLISON BROWN
Title or Position: SECRETARY/MANAGING MEMBER
Credential:
Phone: 502-627-7100