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General NPI Number Information
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NPI Number | 1548555154
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Entity Type | Organization
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Legal Business Name | VIPHARMACY
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 1558 10TH ST # B2
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City | SANTA MONICA
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State | CA
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Zip | 90401-2855
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Country | US
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Telephone | 310-927-8434
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Fax |
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Provider Business Mailing Address
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Address Line | 832 3RD ST APT 405
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City | SANTA MONICA
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State | CA
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Zip | 90403-1156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | LALEH TAHERI
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Credential |
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Telephone | 310-927-8434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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