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General NPI Number Information
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NPI Number | 1053671800
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Entity Type | Organization
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Legal Business Name | MISHNIK PHARMACY SERVICES, INC.
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 05/25/2012
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Provider Practice Location Address
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Address Line | 1960 SEQUOIA AVE SUITE 3
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City | SIMI VALLEY
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State | CA
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Zip | 93063-3176
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Country | US
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Telephone | 805-416-8900
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Fax | 805-823-7767
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Provider Business Mailing Address
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Address Line | PO BOX 940816
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City | SIMI VALLEY
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State | CA
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Zip | 93094-0816
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Country | US
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Telephone | 805-258-6569
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Fax | 805-823-7767
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Authorized Official
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Title or Position | CHIEF PHARMACIST
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Name | MR. AMGAD MOHSEN MASIH
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Credential | RPH
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Telephone | 805-258-6569
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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 | 50179
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License Number State | CA
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