Healthcare Provider Details

I. General information

NPI: 1144201237
Provider Name (Legal Business Name): MJM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24242 LYONS AVE
NEWHALL CA
91321-2343
US

IV. Provider business mailing address

24242 LYONS AVE
NEWHALL CA
91321-2343
US

V. Phone/Fax

Practice location:
  • Phone: 661-287-9533
  • Fax: 661-287-9221
Mailing address:
  • Phone: 661-287-9533
  • Fax: 661-287-9221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY 45304
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateCA

VIII. Authorized Official

Name: MR. MOAZZEM H. CHOWDHURY
Title or Position: PHARMACIST, OWNER
Credential: R.PH.
Phone: 661-287-9533