Provider Demographics
NPI:1578931606
Name:IPHARMACY INC
Entity Type:Organization
Organization Name:IPHARMACY INC
Other - Org Name:SANTA FE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PIC/AO
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:909-342-9181
Mailing Address - Street 1:12916 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4121
Mailing Address - Country:US
Mailing Address - Phone:909-342-9181
Mailing Address - Fax:909-342-9172
Practice Address - Street 1:12916 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4121
Practice Address - Country:US
Practice Address - Phone:909-342-9181
Practice Address - Fax:909-342-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-06
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY537063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154307OtherPK