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General NPI Number Information
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NPI Number | 1457422479
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Entity Type | Organization
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Legal Business Name | RX INGREDIENTS INC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 12/18/2016
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Provider Practice Location Address
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Address Line | 7107 VALJEAN AVE
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City | VAN NUYS
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State | CA
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Zip | 91406-3917
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Country | US
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Telephone | 818-849-5611
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Fax | 818-646-0308
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Provider Business Mailing Address
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Address Line | 7107 VALJEAN AVE
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City | VAN NUYS
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State | CA
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Zip | 91406-3917
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Country | US
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Telephone | 818-849-5611
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Fax | 818-646-0308
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DEANNA AZRILYAN
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Credential |
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Telephone | 818-849-5611
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY48315
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License Number State | CA
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