Healthcare Provider Details

I. General information

NPI: 1437622727
Provider Name (Legal Business Name): EXRX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 01/26/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14248 OXNARD ST STE B
VAN NUYS CA
91401-3608
US

IV. Provider business mailing address

14248 OXNARD ST STE B
VAN NUYS CA
91401-3608
US

V. Phone/Fax

Practice location:
  • Phone: 848-570-8340
  • Fax: 818-647-6327
Mailing address:
  • Phone: 848-570-8340
  • Fax: 818-647-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. LEVON LEO DZHRAGATSPANYAN
Title or Position: CEO/SEC/CFO/DIR/PRESIDENT
Credential:
Phone: 818-570-8340