Provider Demographics
NPI:1851450944
Name:AYN PHARMACY CORP
Entity Type:Organization
Organization Name:AYN PHARMACY CORP
Other - Org Name:THE PRESCRIPTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:310-274-7113
Mailing Address - Street 1:9730 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 103 & 114
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2022
Mailing Address - Country:US
Mailing Address - Phone:310-274-7113
Mailing Address - Fax:310-274-2569
Practice Address - Street 1:9730 WILSHIRE BLVD
Practice Address - Street 2:SUITE 103 & 114
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2022
Practice Address - Country:US
Practice Address - Phone:310-274-7113
Practice Address - Fax:310-274-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY41455333600000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0557112OtherNABP
CAPHA414550Medicaid
0557112OtherNABP