Provider Demographics
NPI:1457838831
Name:ROXBURY PHARMACY, INC.
Entity Type:Organization
Organization Name:ROXBURY PHARMACY, INC.
Other - Org Name:ENCORE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE AND SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALIFIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-271-2600
Mailing Address - Street 1:465 N ROXBURY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4271
Mailing Address - Country:US
Mailing Address - Phone:310-271-2600
Mailing Address - Fax:310-271-2601
Practice Address - Street 1:465 N ROXBURY DR # 103
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4206
Practice Address - Country:US
Practice Address - Phone:310-720-3969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy