Provider Demographics
NPI:1689784845
Name:ROYAL CARE PHARMACY
Entity Type:Organization
Organization Name:ROYAL CARE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SVERDLOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-850-0722
Mailing Address - Street 1:7300 W SUNSET BLVD
Mailing Address - Street 2:#L
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3429
Mailing Address - Country:US
Mailing Address - Phone:323-850-0722
Mailing Address - Fax:323-850-0246
Practice Address - Street 1:7300 W SUNSET BLVD
Practice Address - Street 2:#L
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3429
Practice Address - Country:US
Practice Address - Phone:323-850-0722
Practice Address - Fax:323-850-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5510620001Medicare NSC