Provider Demographics
NPI:1255174520
Name:ENCINO FAMILY PHARMACY INC
Entity type:Organization
Organization Name:ENCINO FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:KOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-387-8119
Mailing Address - Street 1:16060 VENTURA BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4427
Mailing Address - Country:US
Mailing Address - Phone:818-387-8119
Mailing Address - Fax:
Practice Address - Street 1:16060 VENTURA BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4427
Practice Address - Country:US
Practice Address - Phone:818-387-8119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy