Provider Demographics
NPI:1063925493
Name:KINDRED CARE INC
Entity type:Organization
Organization Name:KINDRED CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:YOULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-880-8816
Mailing Address - Street 1:26500 AGOURA RD STE 111
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3562
Mailing Address - Country:US
Mailing Address - Phone:818-880-8816
Mailing Address - Fax:877-963-8710
Practice Address - Street 1:26500 AGOURA RD STE 111
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3562
Practice Address - Country:US
Practice Address - Phone:818-880-8816
Practice Address - Fax:877-963-8710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA557633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY55763OtherBOARD OF PHARMACY PERMIT