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General NPI Number Information
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NPI Number | 1548453707
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Entity Type | Organization
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Legal Business Name | VISITING NURSE HOME PHARMACY, LLC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 1026 N LAKE ST
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City | BURBANK
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State | CA
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Zip | 91502-1624
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Country | US
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Telephone | 818-843-6550
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Fax | 818-843-6514
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Provider Business Mailing Address
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Address Line | 1026 N LAKE ST
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City | BURBANK
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State | CA
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Zip | 91502-1624
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Country | US
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Telephone | 818-843-6550
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Fax | 818-843-6514
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Authorized Official
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Title or Position | VP FINANCE & CFO
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Name | KENNETH KANG
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Credential |
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Telephone | 818-843-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHY 36971
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License Number State | CA
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