MEDICARE: NOVELLA PHARMACY

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1922940634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVELLA PHARMACY

Provider Business Mailing Address
First Line	:	3355 COCHRAN ST STE 204
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2510
Country	:	US
Telephone Number	:	805-980-7767
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 COCHRAN ST STE 204
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-2510
Country	:	US
Telephone Number	:	805-980-7767
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARAL HINTIRYAN
Credential	:
Telephone Number	:	805-980-7767

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “NOVELLA PHARMACY ” Practice Location

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