MEDICARE: WESTCHESTER PHARMACY 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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY55569	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1997522	OTHER		PK

General Provider Information

NPI Number	:	1205930252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCHESTER PHARMACY INC

Provider Business Mailing Address
First Line	:	8930 S SEPULVEDA BLVD
Second Line	:	SUITE 103
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3606
Country	:	US
Telephone Number	:	310-670-3463
Fax Number	:	310-670-4038

Provider Business Practice Location Address
First Line	:	8930 S SEPULVEDA BLVD
Second Line	:	SUITE 103
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3606
Country	:	US
Telephone Number	:	310-670-3463
Fax Number	:	310-670-4038

Authorized Official
Title or Position	:	OWNER/PIC/AO
Name	:	ERIN MARTEN
Credential	:	RPH
Telephone Number	:	310-670-3463

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	04/20/2017

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Directions to “WESTCHESTER PHARMACY INC ” Practice Location

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