Provider Demographics
NPI:1265946545
Name:CYNOB PHARMACY LLC
Entity type:Organization
Organization Name:CYNOB PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:OBINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEREKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:562-474-8005
Mailing Address - Street 1:8731 LOS COYOTES DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1027
Mailing Address - Country:US
Mailing Address - Phone:310-256-8332
Mailing Address - Fax:
Practice Address - Street 1:13041 ROSECRANS AVE STE 206
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-0505
Practice Address - Country:US
Practice Address - Phone:562-474-8005
Practice Address - Fax:562-474-8332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-26
Last Update Date:2017-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy