Provider Demographics
NPI:1326346735
Name:KVP PHARMACY
Entity Type:Organization
Organization Name:KVP PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-291-0547
Mailing Address - Street 1:PO BOX 250310
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91225-0310
Mailing Address - Country:US
Mailing Address - Phone:818-502-9577
Mailing Address - Fax:800-611-6907
Practice Address - Street 1:440 W BROADWAY
Practice Address - Street 2:STE B
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1203
Practice Address - Country:US
Practice Address - Phone:818-502-9577
Practice Address - Fax:800-611-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50535333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy