Provider Demographics
NPI:1326822263
Name:MED CORNER PHARMACY INC
Entity Type:Organization
Organization Name:MED CORNER PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLYMPIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGRIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-646-0249
Mailing Address - Street 1:17627 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3842
Mailing Address - Country:US
Mailing Address - Phone:818-646-0249
Mailing Address - Fax:818-646-0275
Practice Address - Street 1:17627 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3842
Practice Address - Country:US
Practice Address - Phone:818-646-0249
Practice Address - Fax:818-646-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy