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General NPI Number Information
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NPI Number | 1396132049
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Entity Type | Organization
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Legal Business Name | LIFEQUESTS LLC
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 1315 N BULLIS RD 16
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City | COMPTON
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State | CA
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Zip | 90221-1650
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Country | US
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Telephone | 818-284-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 1315 N BULLIS RD 2
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City | COMPTON
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State | CA
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Zip | 90221-1650
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Country | US
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Telephone | 818-284-7464
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | MISS LAURA AZIZYANTS
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Credential | PHARM D INTERN
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Telephone | 818-284-7474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State | CA
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