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General NPI Number Information
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NPI Number | 1295812345
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Entity Type | Organization
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Legal Business Name | CHURCH CAPITAL LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 7400 VAN NUYS BLVD UNIT 101
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City | VAN NUYS
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State | CA
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Zip | 91405-1966
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Country | US
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Telephone | 818-997-7000
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Fax | 818-997-7003
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Provider Business Mailing Address
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Address Line | 7400 VAN NUYS BLVD UNIT 101
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City | VAN NUYS
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State | CA
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Zip | 91405-1966
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Country | US
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Telephone | 818-997-7000
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Fax | 818-997-7003
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Authorized Official
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Title or Position | MEMBER/PIC
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Name | MR. ARMEN MANOUKIAN
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Credential | RPH
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Telephone | 818-997-7000
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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 | PHY51231
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY 51231
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License Number State | CA
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