Healthcare Provider Details

I. General information

NPI: 1043838691
Provider Name (Legal Business Name): CV HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 VAN NUYS BLVD
PANORAMA CITY CA
91402-4810
US

IV. Provider business mailing address

8215 VAN NUYS BLVD
PANORAMA CITY CA
91402-4810
US

V. Phone/Fax

Practice location:
  • Phone: 818-787-4490
  • Fax: 818-787-4494
Mailing address:
  • Phone: 818-787-4490
  • Fax: 818-787-4494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHARON RUTH CATHERS
Title or Position: VP OPERATIONS
Credential: RN
Phone: 818-787-4490