Provider Demographics
NPI:1275930638
Name:TRIPLE S R PHARMACY INC
Entity Type:Organization
Organization Name:TRIPLE S R PHARMACY INC
Other - Org Name:HOPE SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:SARKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JARAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:800-557-5555
Mailing Address - Street 1:330 N BRAND BLVD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2308
Mailing Address - Country:US
Mailing Address - Phone:800-557-5555
Mailing Address - Fax:800-557-9095
Practice Address - Street 1:330 N BRAND BLVD
Practice Address - Street 2:SUITE 155
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2308
Practice Address - Country:US
Practice Address - Phone:800-557-5555
Practice Address - Fax:800-557-9095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY554173336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56-53515OtherNCPDP
CAPHY55417OtherSTATE BOARD OF PHARMACY PERMIT