Type | Company | [sources] | |||
---|---|---|---|---|---|
Name | Miracle Care, Inc. dba The Medicine Shoppe | [sources] | |||
Incorporation date | not available | [sources] | |||
Jurisdiction | not available | [sources] | |||
Country | United States | [sources] | |||
NPI | 1710992367 | [sources] | |||
Registration number | PHY 51652 | [sources] | |||
Sector | Entity/Corporation | [sources] | |||
Address | 19225 Ventura Blvd., Tarzana, CA, 91356 | [sources] | |||
Last change | Last processed | First seen |
Medical providers suspended from or otherwise deemed ineligible to participate in California's Medicaid program.
United States · DHCS
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