Healthcare Provider Details

I. General information

NPI: 1770578981
Provider Name (Legal Business Name): SERV-U-PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 11/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2034 W PICO BLVD
LOS ANGELES CA
90006-5011
US

IV. Provider business mailing address

2034 W PICO BLVD
LOS ANGELES CA
90006-5011
US

V. Phone/Fax

Practice location:
  • Phone: 213-385-5225
  • Fax: 213-385-5222
Mailing address:
  • Phone: 213-385-5225
  • Fax: 213-385-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY51878
License Number StateCA

VIII. Authorized Official

Name: ROGER TSENG
Title or Position: OWNER
Credential:
Phone: 213-385-5225