Provider Demographics
NPI:1124387998
Name:DUOMO PHARMACY INC
Entity Type:Organization
Organization Name:DUOMO PHARMACY INC
Other - Org Name:DUOMO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-980-4999
Mailing Address - Street 1:12157 VICTORY BLVD
Mailing Address - Street 2:#A
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3204
Mailing Address - Country:US
Mailing Address - Phone:818-980-4999
Mailing Address - Fax:818-980-4992
Practice Address - Street 1:12157 VICTORY BLVD
Practice Address - Street 2:#A
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3204
Practice Address - Country:US
Practice Address - Phone:818-980-4999
Practice Address - Fax:818-980-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY50960333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY50960OtherSTATE BOARD OF PHARMACY RETAIL PERMIT