Healthcare Provider Details
I. General information
NPI: 1073625067
Provider Name (Legal Business Name): ANEROL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3400 WHITTIER BLVD
LOS ANGELES CA
90023-1708
US
IV. Provider business mailing address
PO BOX 39879
DOWNEY CA
90239-0879
US
V. Phone/Fax
- Phone: 323-268-3384
- Fax: 323-268-1940
- Phone: 323-268-3384
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHY35861 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
BALL
Title or Position: PIC
Credential: PHARM D
Phone: 323-268-3384