Provider Demographics
NPI:1922881564
Name:XPRESS MED LA RX INC
Entity Type:Organization
Organization Name:XPRESS MED LA RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/CFO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:818-804-8909
Mailing Address - Street 1:16430 VANOWEN ST UNIT 101-103
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4729
Mailing Address - Country:US
Mailing Address - Phone:818-804-8909
Mailing Address - Fax:818-804-8994
Practice Address - Street 1:16430 VANOWEN ST UNIT 101-103
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4729
Practice Address - Country:US
Practice Address - Phone:818-804-8909
Practice Address - Fax:818-804-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59104OtherBOARD OF PHARMACY