Provider Demographics
NPI:1518199942
Name:DR. MED, INC.
Entity Type:Organization
Organization Name:DR. MED, INC.
Other - Org Name:DR. PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMIRIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:818-991-1901
Mailing Address - Street 1:706 LINDERO CANYON ROAD
Mailing Address - Street 2:SUITE 776
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5463
Mailing Address - Country:US
Mailing Address - Phone:818-991-1901
Mailing Address - Fax:818-991-1903
Practice Address - Street 1:706 LINDERO CANYON ROAD
Practice Address - Street 2:SUITE 776
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5463
Practice Address - Country:US
Practice Address - Phone:818-991-1901
Practice Address - Fax:818-991-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6580080001Medicare NSC