Healthcare Provider Details

I. General information

NPI: 1407920929
Provider Name (Legal Business Name): RX UNLIMITED PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16673 ROSCOE BLVD
NORTH HILLS CA
91343-6109
US

IV. Provider business mailing address

16673 ROSCOE BLVD
NORTH HILLS CA
91343-6109
US

V. Phone/Fax

Practice location:
  • Phone: 818-781-2400
  • Fax: 818-781-2401
Mailing address:
  • Phone: 818-781-2400
  • Fax: 818-781-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number50302
License Number StateCA

VIII. Authorized Official

Name: BRIAN GOLDSTEIN
Title or Position: MANAGER
Credential:
Phone: 310-360-0000