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NPI Code Detail

MEDICARE: OMEGA CARE PHARMACY INC

MEDICARE: OMEGA CARE 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
13336C0003XCommunity/Retail PharmacyCA

General Provider Information

NPI Number : 1942667191
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMEGA CARE PHARMACY INC
Provider Business Mailing Address
First Line : 4611 VAN NUYS BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-2916
Country : US
Telephone Number : 818-849-6466
Fax Number : 818-849-5484
Provider Business Practice Location Address
First Line : 4611 VAN NUYS BLVD
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-2916
Country : US
Telephone Number : 818-849-6466
Fax Number : 818-849-5484
Authorized Official
Title or Position : PRESIDENT
Name : MR. EMIL BURNAZYAN
Credential :
Telephone Number : 818-849-6466
Provider Enumeration Date : 01/19/2016
Last Update Date : 08/12/2016

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Directions to “OMEGA CARE PHARMACY INC ” Practice Location

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