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PETICUB NPI 1790049484


NPI Information

NPI: 1790049484
Provider Name: PETICUB

Doing Business As: PETICUB

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
1804 S LA CIENEGA BLVD # 102
LOS ANGELES, CA
ZIP 90035
Phone: (310) 839-7387
Get Directions

PETICUB is a community/retail pharmacy pharmacy in Los Angeles, CA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PETICUB NPI is 1790049484. The provider is registered as an organization entity type.
The provider Is Doing Business As Peticub.

The provider's business location address is:

1804 S LA CIENEGA BLVD # 102
LOS ANGELES, CA
ZIP 90035-670
Phone: (310) 839-7387
Fax: (310) 288-9141

The provider's authorized official is Rabin Shaoulian .
The authorized official title is Location Manager and has the following contact phone number (310) 839-7387.

The enumeration date for this NPI number is 6/27/2012 and was last updated on 8/21/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336M0002XPharmacyMail Order PharmacyNo
23336H0001XPharmacyHome Infusion Therapy PharmacyNo
33336C0004XPharmacyCompounding PharmacyNo
4333600000XPharmacyNo
53336C0003XPharmacyCommunity/Retail PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15644821OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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