Provider Demographics
NPI:1093945164
Name:CITY PHARMACY
Entity Type:Organization
Organization Name:CITY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAGARSHAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-988-8089
Mailing Address - Street 1:6262 VAN NUYS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-2769
Mailing Address - Country:US
Mailing Address - Phone:818-988-8089
Mailing Address - Fax:818-988-8079
Practice Address - Street 1:6262 VAN NUYS BLVD STE D
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2769
Practice Address - Country:US
Practice Address - Phone:818-988-8089
Practice Address - Fax:818-988-8079
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAK. FOUNDATION, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251K00000X, 251V00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable