Healthcare Provider Details

I. General information

NPI: 1790507002
Provider Name (Legal Business Name): PILLMAXX CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2061 N LOS ROBLES AVE STE 103
PASADENA CA
91104-1157
US

IV. Provider business mailing address

2061 N LOS ROBLES AVE STE 103
PASADENA CA
91104-1157
US

V. Phone/Fax

Practice location:
  • Phone: 626-900-8694
  • Fax:
Mailing address:
  • Phone: 626-900-8694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ARIS ESKANDARI
Title or Position: CEO
Credential:
Phone: 626-900-8694