Provider Demographics
NPI:1073973715
Name:VETERANS PHARMACY INC
Entity Type:Organization
Organization Name:VETERANS PHARMACY INC
Other - Org Name:VETERANS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SARKIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHILEGEVORKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-849-6460
Mailing Address - Street 1:14105 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4908
Mailing Address - Country:US
Mailing Address - Phone:818-849-6460
Mailing Address - Fax:818-849-5882
Practice Address - Street 1:14105 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-4908
Practice Address - Country:US
Practice Address - Phone:818-849-6460
Practice Address - Fax:818-849-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 542883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY54288OtherSTATE BOARD OF PHARMACY
CAFV5889920OtherCONTROLLED SUBSTANCE REGISTRATION CERTIFICATE
CA56-59125OtherNCPDP PROVIDER