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General NPI Number Information
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NPI Number | 1831110881
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Entity Type | Organization
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Legal Business Name | FSQ PHARMACY HOLDINGS LLC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 7301 MEDICAL CENTER DR
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City | WEST HILLS
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State | CA
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Zip | 91307-1904
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Country | US
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Telephone | 818-887-4670
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Fax | 818-887-0473
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Provider Business Mailing Address
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Address Line | 7301 MEDICAL CENTER DR
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City | WEST HILLS
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State | CA
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Zip | 91307-1904
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Country | US
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Telephone | 818-887-4670
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Fax | 818-887-0473
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Authorized Official
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Title or Position | VP PHCY OPS
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Name | STEVEN BERRY
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Credential |
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Telephone | 617-796-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional 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 | 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 #3
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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 #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY47416
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License Number State | CA
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