Medico Pharmacy
LBN: Evergreeen Rx Inc
Medico Pharmacy is an health care organization with primary practice located at 11779 Santa Monica Blvd , Los Angeles CA 90025-2843. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Evergreeen Rx Inc can be contacted via phone (310) 444-9011, or through Akopyan, Yury via phone (310) 444-9011.
Contact Information
Primary practice address
11779 Santa Monica Blvd
Los Angeles CA 90025-2843
Phone: (310) 444-9011
Fax: (310) 444-0418
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY51906 | California |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1346241700 |
|---|---|
| LBN Legal business name | Evergreeen Rx Inc |
| DBA Doing business as | Medico Pharmacy |
| Authorized official | Akopyan, Yury |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 9th, 2005 |
| Last updated | Jul 19th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346241700 | NPPES |
| California | MEDICAID | 1346241700 | |
| California | Other | 2151974 |
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