Provider Demographics
NPI:1235457813
Name:AMERICOMP PHARMACY
Entity Type:Organization
Organization Name:AMERICOMP PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-653-2317
Mailing Address - Street 1:1219 N PACIFIC AVE
Mailing Address - Street 2:SUITE #B
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1219 N PACIFIC AVE
Practice Address - Street 2:SUITE #B
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-1619
Practice Address - Country:US
Practice Address - Phone:818-653-2317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY502443336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy