=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144195678
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPIRITED HRACH OF THE VALLEY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2025
-----------------------------------------------------
Last Update Date | 11/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7616 FOOTHILL BLVD STE A
-----------------------------------------------------
City | TUJUNGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91042-2186
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-273-9338
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7616 FOOTHILL BLVD STE A
-----------------------------------------------------
City | TUJUNGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91042-2186
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-273-9338
-----------------------------------------------------
Fax | 818-273-4111
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SEC/CFO/DIR
-----------------------------------------------------
Name | KRISTINEH YOUSEFIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-378-5999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------