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General NPI Number Information
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NPI Number | 1790237113
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Entity Type | Organization
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Legal Business Name | HEALING COMPOUNDS INC
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Dates
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Enumeration Date | 11/02/2016
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Last Update Date | 11/02/2016
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Provider Practice Location Address
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Address Line | 4955 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1801
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Country | US
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Telephone | 818-905-0669
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Fax | 818-905-0016
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Provider Business Mailing Address
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Address Line | 4955 VAN NUYS BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1801
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Country | US
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Telephone | 818-905-0669
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Fax | 818-905-0016
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Authorized Official
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Title or Position | PRESIDENT / PHARMACIST IN CHARGE
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Name | DR. BABAK R. KOHANTEB
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Credential | PHARM D
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Telephone | 818-905-0669
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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 | PHY43586
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PHY43586
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY43586
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License Number State | CA
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