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General NPI Number Information
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NPI Number | 1710992367
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Entity Type | Organization
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Legal Business Name | MIRACLE CARE INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 19225 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-3122
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Country | US
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Telephone | 818-996-2878
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Fax | 818-996-2877
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Provider Business Mailing Address
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Address Line | 19225 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-3122
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Country | US
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Telephone | 818-996-2878
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Fax | 818-996-2877
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Authorized Official
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Title or Position | OWNER
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Name | ARTHUR KARAGEZYAN
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Credential |
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Telephone | 818-996-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY51652
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License Number State | CA
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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 | PHY51652
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY51652
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License Number State | CA
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