Provider Demographics
NPI:1568448454
Name:MAY NABI
Entity Type:Organization
Organization Name:MAY NABI
Other - Org Name:TOLUCA VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAY
Authorized Official - Middle Name:
Authorized Official - Last Name:NABI KANDELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-846-7444
Mailing Address - Street 1:4201 W ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4142
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4142
Practice Address - Country:US
Practice Address - Phone:818-846-7444
Practice Address - Fax:818-846-7416
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAY NABI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-12-21
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY450953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0511229OtherOTHER ID NUMBER
CAPHA450950Medicaid
0511229OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1265300001Medicare NSC