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NPI Code Detail

MEDICARE: GREYWELL PHARMACY INC

MEDICARE: GREYWELL 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PHY58650OTHERCABOARD OF PHARMACY
256-49910OTHERCANCPDP PROVIDER NUMBER

General Provider Information

NPI Number : 1841611902
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREYWELL PHARMACY INC
Provider Business Mailing Address
First Line : 10672 RIVERSIDE DR
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91602-2319
Country : US
Telephone Number : 818-306-5500
Fax Number : 818-287-0999
Provider Business Practice Location Address
First Line : 10672 RIVERSIDE DR
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91602-2319
Country : US
Telephone Number : 818-306-5500
Fax Number : 818-287-0999
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MIKHAIL LVOVICH
Credential : PHARM D
Telephone Number : 818-306-5500
Provider Enumeration Date : 12/16/2013
Last Update Date : 06/29/2022

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Directions to “GREYWELL PHARMACY INC ” Practice Location

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