Provider Demographics
NPI:1194433938
Name:ANTELOPE VALLEY HEALTH CARE DISTRICT
Entity type:Organization
Organization Name:ANTELOPE VALLEY HEALTH CARE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZABEGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-949-5512
Mailing Address - Street 1:1600 W AVENUE J
Mailing Address - Street 2:INFUSION PHARMACY
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-949-5000
Mailing Address - Fax:
Practice Address - Street 1:1600 W AVENUE J
Practice Address - Street 2:INFUSION PHARMACY
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534
Practice Address - Country:US
Practice Address - Phone:661-949-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANTELOPE VALLEY HEALTH CARE DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy