Amanita Rx, Inc.

LBN: Amanita Rx, Inc.
Amanita Rx, Inc. is an health care organization with primary practice located at 1250 La Venta Dr Ste 114, Westlake Village CA 91361-3702. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Amanita Rx, Inc. can be contacted via phone (805) 497-3974, or through Patel, Seema via phone (818) 389-6381.

Contact Information

Primary practice address
1250 La Venta Dr Ste 114 Westlake Village CA 91361-3702
Fax: (805) 494-0103
Website:
Authorized official contact:
Name: Patel, Seema

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY55875 California
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1285649897
LBN Legal business name Amanita Rx, Inc.
DBA Doing business as
Authorized official Patel, Seema
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2006
Last updated Dec 28th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285649897 NPPES
Other 2132912 PK

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