Provider Demographics
NPI:1043447204
Name:DR N VAHEDI PHARMACY INC
Entity Type:Organization
Organization Name:DR N VAHEDI PHARMACY INC
Other - Org Name:FUSION RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-877-9393
Mailing Address - Street 1:2001 WESTWOOD BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6328
Mailing Address - Country:US
Mailing Address - Phone:310-204-6676
Mailing Address - Fax:310-204-6678
Practice Address - Street 1:2001 WESTWOOD BLVD STE A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6328
Practice Address - Country:US
Practice Address - Phone:310-204-6676
Practice Address - Fax:310-204-6678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336M0002X
CAPHY499373336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2120895OtherPK