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General NPI Number Information
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NPI Number | 1265511661
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Entity Type | Organization
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Legal Business Name | UNITED PHARMACY, INC
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | 1129 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1403
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Country | US
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Telephone | 310-247-0247
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Fax | 310-247-0248
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Provider Business Mailing Address
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Address Line | 1129 S ROBERTSON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-1403
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Country | US
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Telephone | 310-247-0247
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Fax | 310-247-0248
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARID RAPHAEL POURMORADY
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Credential | RPH
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Telephone | 310-247-0247
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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 | PHY 46362
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY46362
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License Number State | CA
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