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NPI Code Detail

MEDICARE: MAPLE MEDICAL PHARMACY, INC

MEDICARE: MAPLE MEDICAL 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 Pharmacy50822CA

General Provider Information

NPI Number : 1962740787
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAPLE MEDICAL PHARMACY, INC
Provider Business Mailing Address
First Line : 8950 W OLYMPIC BLVD
Second Line : STE 487
City : BEVERLY HILLS
State : CA
Zip : 90211-3561
Country : US
Telephone Number : 323-343-3922
Fax Number :
Provider Business Practice Location Address
First Line : 9231 W OLYMPIC BLVD
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90212-4658
Country : US
Telephone Number : 310-343-3922
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. ABRAHAM KHORSHAD
Credential :
Telephone Number : 310-343-3922
Provider Enumeration Date : 01/29/2013
Last Update Date : 01/29/2013

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Directions to “MAPLE MEDICAL PHARMACY, INC ” Practice Location

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