Provider Demographics
NPI:1477618890
Name:LUXURY PHARMACEUTICALS, INC.
Entity Type:Organization
Organization Name:LUXURY PHARMACEUTICALS, INC.
Other - Org Name:H K VALLEY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PIC
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:EUNKYUNG
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-708-0728
Mailing Address - Street 1:17643 SHERMAN WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-3510
Mailing Address - Country:US
Mailing Address - Phone:818-708-0728
Mailing Address - Fax:818-708-1253
Practice Address - Street 1:17643 SHERMAN WAY STE 104
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3510
Practice Address - Country:US
Practice Address - Phone:818-708-0728
Practice Address - Fax:818-708-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY486673336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1993090OtherPK
1993090OtherPK