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General NPI Number Information
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NPI Number | 1396776068
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Entity Type | Organization
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Legal Business Name | PHILLERS
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 20056 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2637
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Country | US
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Telephone | 818-348-0860
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Fax | 818-884-3290
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Provider Business Mailing Address
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Address Line | 20056 VENTURA BLVD
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2696
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Country | US
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Telephone | 818-348-0860
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Fax | 818-884-3290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILIP MICHAEL GEBROE
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Credential | PHARM.D.
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Telephone | 818-348-0860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY44960
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License Number State | CA
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