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General NPI Number Information
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NPI Number | 1922648948
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Entity Type | Organization
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Legal Business Name | VERTEXRX PHARMACY INCORPORATED
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 11273 LAUREL CANYON BLVD STE 4
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4359
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Country | US
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Telephone | 818-638-9652
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Fax | 818-638-9653
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Provider Business Mailing Address
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Address Line | 11273 LAUREL CANYON BLVD STE 4
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City | SAN FERNANDO
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State | CA
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Zip | 91340-4359
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Country | US
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Telephone | 818-638-9652
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Fax | 818-638-9653
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Authorized Official
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Title or Position | CEO
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Name | ANGEL SAMVALIAN
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Credential |
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Telephone | 818-638-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 |
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License Number State |
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