Provider Demographics
NPI:1235859158
Name:LV PHARMACY INC
Entity Type:Organization
Organization Name:LV PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUSINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRGATBASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-646-0627
Mailing Address - Street 1:14100 MAGNOLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1119
Mailing Address - Country:US
Mailing Address - Phone:818-646-0627
Mailing Address - Fax:818-646-0628
Practice Address - Street 1:14100 MAGNOLIA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1119
Practice Address - Country:US
Practice Address - Phone:818-646-0627
Practice Address - Fax:818-646-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY58756OtherBOARD OF PHARMACY