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NPI Code Detail

MEDICARE: ND RX INC

MEDICARE: ND RX INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyPHY41698CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11998434OTHERPK

General Provider Information

NPI Number : 1083608103
Entity Type Code : Organization
Provider Name (Legal Business Name) : ND RX INC
Provider Business Mailing Address
First Line : 2428 SANTA MONICA BLVD
Second Line : SUITE 101
City : SANTA MONICA
State : CA
Zip : 90404-2045
Country : US
Telephone Number : 310-453-7843
Fax Number : 310-829-5902
Provider Business Practice Location Address
First Line : 2428 SANTA MONICA BLVD
Second Line : SUITE 101
City : SANTA MONICA
State : CA
Zip : 90404-2045
Country : US
Telephone Number : 310-453-7843
Fax Number : 310-829-5902
Authorized Official
Title or Position : PRESIDENT/CEO/CFO/SECRETARY/DIRECTO
Name : NASTARAN DANYALYAN
Credential : PHARMD
Telephone Number : 310-453-7843
Provider Enumeration Date : 09/02/2005
Last Update Date : 01/22/2024

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Directions to “ND RX INC ” Practice Location

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