Provider Demographics
NPI:1760586713
Name:WESTWOOD PHARMACY PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:WESTWOOD PHARMACY PROFESSIONAL CORPORATION
Other - Org Name:CENTRAL CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKARICIC
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-386-1888
Mailing Address - Street 1:16260 VENTURA BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2203
Mailing Address - Country:US
Mailing Address - Phone:818-386-1888
Mailing Address - Fax:818-386-1188
Practice Address - Street 1:16260 VENTURA BLVD
Practice Address - Street 2:STE 100
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2203
Practice Address - Country:US
Practice Address - Phone:818-386-1888
Practice Address - Fax:818-386-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY473333336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA473330Medicaid
1995788OtherPK
CAPHA446290Medicaid
0556095OtherOTHER ID NUMBER-COMMERCIAL NUMBER
CA5592870001Medicare NSC