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General NPI Number Information
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NPI Number | 1043104599
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Entity Type | Organization
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Legal Business Name | WELLNESS LTC PHARMACY
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 19944 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2629
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Country | US
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Telephone | 818-854-6600
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Fax | 818-664-4204
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Provider Business Mailing Address
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Address Line | 19944 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2629
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Country | US
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Telephone | 818-854-6600
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Fax | 818-664-4204
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Authorized Official
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Title or Position | PHARMACIST
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Name | BAHAREH GOLESTANIPOUR
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Credential |
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Telephone | 818-518-4394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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