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General NPI Number Information
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NPI Number | 1013136043
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Entity Type | Organization
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Legal Business Name | CAMDEN PHARMACY OF BEVERLY HILLS INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2016
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Provider Practice Location Address
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Address Line | 414 N CAMDEN DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4532
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Country | US
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Telephone | 310-273-3363
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Fax |
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Provider Business Mailing Address
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Address Line | 414 N CAMDEN DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4532
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Country | US
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Telephone | 310-273-3363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY GROSS
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Credential |
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Telephone | 310-273-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY47557
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License Number State | CA
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