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General NPI Number Information
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NPI Number | 1134371230
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Entity Type | Organization
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Legal Business Name | SUPERIOR PHARMACY INC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 11755 VICTORY BLVD STE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3448
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Country | US
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Telephone | 818-691-3351
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Fax | 818-691-3371
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Provider Business Mailing Address
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Address Line | 11755 VICTORY BLVD STE 102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3448
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Country | US
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Telephone | 818-691-3351
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Fax | 818-691-3371
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARITA KHLGHATYAN
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Credential |
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Telephone | 818-691-3351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY49215
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License Number State | CA
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