=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912149543
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARROW-MED RX INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2009
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5233 MELROSE AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90038-3144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-836-0007
-----------------------------------------------------
Fax | 323-962-3404
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5233 MELROSE AVE
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90038-3144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 323-836-0007
-----------------------------------------------------
Fax | 323-962-3404
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | MR. ALEXANDR AKOPNIK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 323-836-0007
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | PHY50759
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number | PHY 50759
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number | PHY 50759
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------