Healthcare Provider Details

I. General information

NPI: 1235523093
Provider Name (Legal Business Name): CANBY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18327 SHERMAN WAY
RESEDA CA
91335-4425
US

IV. Provider business mailing address

18327 SHERMAN WAY
RESEDA CA
91335-4425
US

V. Phone/Fax

Practice location:
  • Phone: 747-267-2777
  • Fax: 747-267-1777
Mailing address:
  • Phone: 747-267-2777
  • Fax: 747-267-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. LIANA MARGARYAN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 747-267-2777