Provider Demographics
NPI:1902029614
Name:COUNTY OF LOS ANGELES
Entity Type:Organization
Organization Name:COUNTY OF LOS ANGELES
Other - Org Name:LOS ANGELES COUNTY HIGH DESERT REGIONAL HEALTH CENTER PHARMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY SERVICES CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANOUSSI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:661-471-4107
Mailing Address - Street 1:335 EAST AVE I
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535
Mailing Address - Country:US
Mailing Address - Phone:661-471-4100
Mailing Address - Fax:661-524-2920
Practice Address - Street 1:335 EAST AVE I
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535
Practice Address - Country:US
Practice Address - Phone:661-471-4100
Practice Address - Fax:661-524-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHE 421953336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0534544OtherNABP