Provider Demographics
NPI:1225337843
Name:NUTRITION PLUS INC
Entity Type:Organization
Organization Name:NUTRITION PLUS INC
Other - Org Name:IV MED SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AFROOZ
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVANFARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-273-1939
Mailing Address - Street 1:11207 S LA CIENEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-6112
Mailing Address - Country:US
Mailing Address - Phone:310-670-6337
Mailing Address - Fax:877-513-0770
Practice Address - Street 1:11207 S LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-6112
Practice Address - Country:US
Practice Address - Phone:310-670-6337
Practice Address - Fax:877-513-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336S0011X
CAPHY505933336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2129562OtherPK