Provider Demographics
NPI:1851615363
Name:A G & Y ENTERPRISES, INC.
Entity Type:Organization
Organization Name:A G & Y ENTERPRISES, INC.
Other - Org Name:OWL WESTERN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/RPH
Authorized Official - Prefix:
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:GINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-209-8160
Mailing Address - Street 1:1009 W SAN BERNARDINO RD
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-4106
Mailing Address - Country:US
Mailing Address - Phone:626-209-8160
Mailing Address - Fax:626-209-8172
Practice Address - Street 1:1009 W SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-4106
Practice Address - Country:US
Practice Address - Phone:626-209-8160
Practice Address - Fax:626-209-8172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50226332BN1400X, 332BP3500X, 332BX2000X, 3336H0001X, 3336L0003X, 335E00000X
3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5637662OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CA1851615363Medicaid
CALSC 100893OtherSTERILE COMPOUNDING LICENSE
CAPHY 53855OtherBOARD OF PHARMACY LICENSE
CAPHY 53855OtherBOARD OF PHARMACY LICENSE
CA158134OtherFURNITURE AND BEDDING RETAILER