Healthcare Provider Details

I. General information

NPI: 1770668907
Provider Name (Legal Business Name): WESTWOOD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 BIRCH ST
WESTWOOD CA
96137-0880
US

IV. Provider business mailing address

PO BOX 880
WESTWOOD CA
96137-0880
US

V. Phone/Fax

Practice location:
  • Phone: 530-256-3784
  • Fax: 530-256-3942
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY19462
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HARVEY HAMILTON
Title or Position: OWNER
Credential: RPH
Phone: 530-256-3784