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General NPI Number Information
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NPI Number | 1669596128
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Entity Type | Organization
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Legal Business Name | AMC RX PHARMACY, INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 2625 W ALAMEDA AVE STE 110
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City | BURBANK
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State | CA
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Zip | 91505-4815
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Country | US
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Telephone | 818-841-0423
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Fax | 818-841-1508
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Provider Business Mailing Address
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Address Line | 2625 W ALAMEDA AVE STE 110
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City | BURBANK
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State | CA
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Zip | 91505-4815
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Country | US
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Telephone | 818-841-0423
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Fax | 818-841-1508
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DAVID SHALTS
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Credential | PHARM D
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Telephone | 818-841-0423
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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