Provider Demographics
NPI:1699023218
Name:S O PHARMACY INC
Entity Type:Organization
Organization Name:S O PHARMACY INC
Other - Org Name:SHERMAN OAKS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:FARZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-990-4500
Mailing Address - Street 1:4520 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2913
Mailing Address - Country:US
Mailing Address - Phone:818-990-4500
Mailing Address - Fax:818-990-7300
Practice Address - Street 1:4520 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2913
Practice Address - Country:US
Practice Address - Phone:818-990-4500
Practice Address - Fax:818-990-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5645126OtherNCPDP PROVIDER IDENTIFICATION NUMBER