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General NPI Number Information
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NPI Number | 1356879787
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Entity Type | Organization
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Legal Business Name | COSMED PHARMACY, INC.
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 6521 VAN NUYS BLVD
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City | VAN NUYS
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State | CA
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Zip | 91401-1425
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Country | US
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Telephone | 818-933-2010
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Fax | 818-933-2018
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Provider Business Mailing Address
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Address Line | 6521 VAN NUYS BLVD
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City | VAN NUYS
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State | CA
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Zip | 91401-1425
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Country | US
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Telephone | 818-933-2010
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Fax | 818-933-2018
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Authorized Official
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Title or Position | CEO
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Name | KHANH-LONG THAI
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Credential | PHARM D
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Telephone | 818-933-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 55488
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License Number State | CA
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