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General NPI Number Information
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NPI Number | 1730608423
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Entity Type | Organization
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Legal Business Name | E.V.A. HEALTH LLC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 15869 AMAR RD
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City | LA PUNTE
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State | CA
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Zip | 91744
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Country | US
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Telephone | 626-261-4400
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Fax | 626-261-4948
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Provider Business Mailing Address
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Address Line | 15869 AMAR RD
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City | LA PUNTE
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State | CA
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Zip | 91744
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Country | US
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Telephone | 626-261-4400
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Fax | 626-261-4948
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Authorized Official
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Title or Position | MEMBER/PIC
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Name | CHADI ABDUL NOUR
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Credential |
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Telephone | 626-261-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 55516
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License Number State | CA
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