Healthcare Provider Details

I. General information

NPI: 1528055407
Provider Name (Legal Business Name): JCH PHARMACY LA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8408 BEVERLY BLVD
LOS ANGELES CA
90048
US

IV. Provider business mailing address

8408 BEVERLY BLVD
LOS ANGELES CA
90048
US

V. Phone/Fax

Practice location:
  • Phone: 310-358-2400
  • Fax: 310-358-2410
Mailing address:
  • Phone: 310-358-2400
  • Fax: 310-358-2410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHA418600
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY CLINTON HOPKINS
Title or Position: COO
Credential: PHARMD
Phone: 310-358-2400