Healthcare Provider Details

I. General information

NPI: 1962067587
Provider Name (Legal Business Name): NOVA LUXE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13756 VICTORY BLVD
VAN NUYS CA
91401-2324
US

IV. Provider business mailing address

13756 VICTORY BLVD
VAN NUYS CA
91401-2324
US

V. Phone/Fax

Practice location:
  • Phone: 818-809-2383
  • Fax: 818-809-2382
Mailing address:
  • Phone: 818-809-2382
  • Fax: 818-936-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. NUNE ARAMYAN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 818-809-2382