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General NPI Number Information
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NPI Number | 1326346735
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Entity Type | Organization
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Legal Business Name | KVP PHARMACY
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 440 W BROADWAY STE B
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City | GLENDALE
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State | CA
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Zip | 91204-1203
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Country | US
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Telephone | 818-502-9577
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Fax | 800-611-6907
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Provider Business Mailing Address
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Address Line | PO BOX 250310
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City | GLENDALE
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State | CA
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Zip | 91225-0310
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Country | US
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Telephone | 818-502-9577
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Fax | 800-611-6907
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Authorized Official
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Title or Position | OPERATIONS
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Name | MR. DAVIN DEB
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Credential |
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Telephone | 818-291-0547
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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 | 50535
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License Number State | CA
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