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General NPI Number Information
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NPI Number | 1821454554
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Entity Type | Organization
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Legal Business Name | BEVERLY HILLS APOTHECARY LLC
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 432 N BEDFORD DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4301
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Country | US
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Telephone | 310-741-4596
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Fax | 310-741-4597
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Provider Business Mailing Address
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Address Line | 432 N BEDFORD DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4301
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Country | US
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Telephone | 310-741-4596
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Fax | 310-741-4597
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Authorized Official
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Title or Position | PIC, AO
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Name | ROSETTE LEVY
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Credential | RPH
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Telephone | 310-213-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY53740
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License Number State | CA
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