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General NPI Number Information
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NPI Number | 1497742399
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Entity Type | Organization
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Legal Business Name | NORMANDY PHARMACY INC
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 5112 HOLLYWOOD BLVD SUITE 104
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City | LOS ANGELES
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State | CA
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Zip | 90027-6124
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Country | US
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Telephone | 323-913-3337
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Fax | 323-913-0318
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Provider Business Mailing Address
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Address Line | 5112 HOLLYWOOD BLVD SUITE 104
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City | LOS ANGELES
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State | CA
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Zip | 90027-6124
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Country | US
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Telephone | 323-913-3337
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Fax | 323-913-0318
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PETROS NAZARIAN
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Credential |
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Telephone | 323-913-3337
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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 | PHY43795
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License Number State | CA
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