MEDICARE: BEVERLY HILLS TOWER 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
1	183500000X	Pharmacist	PHY36965	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205821253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY HILLS TOWER INC

Provider Business Mailing Address
First Line	:	2080 CENTURY PARK E
Second Line	:	CENTURY CITY MEDICAL PLAZA PHARMACY
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-553-3434
Fax Number	:	310-553-2237

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E
Second Line	:	CENTURY CITY MEDICAL PLAZA PHARMACY
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2001
Country	:	US
Telephone Number	:	310-553-3434
Fax Number	:	310-553-2237

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN NOORVASH
Credential	:	PHARM D
Telephone Number	:	310-553-3434

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	02/13/2008

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