MEDICARE: NATIONAL 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	3336S0011X	Specialty Pharmacy	PHY 50363	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PHY 50363	OTHER	CA	BOARD OF PHARMACY PERMIT

General Provider Information

NPI Number	:	1649641853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL PHARMACY INC

Provider Business Mailing Address
First Line	:	7420 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5605
Country	:	US
Telephone Number	:	323-851-4444
Fax Number	:	800-995-4990

Provider Business Practice Location Address
First Line	:	7420 SANTA MONICA BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-5605
Country	:	US
Telephone Number	:	323-851-4444
Fax Number	:	800-995-4990

Authorized Official
Title or Position	:	PRESIDENT/RPH
Name	:	MR. MICAHEL IMANOEL
Credential	:	PHARM D
Telephone Number	:	323-851-4444

Provider Enumeration Date	:	10/14/2015
Last Update Date	:	10/14/2015

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Directions to “NATIONAL PHARMACY INC ” Practice Location

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