Provider Demographics
NPI:1861512378
Name:OURX PHARMACY,INC.
Entity Type:Organization
Organization Name:OURX PHARMACY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOMAYOON
Authorized Official - Middle Name:
Authorized Official - Last Name:KHORSANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-453-5557
Mailing Address - Street 1:2222 SANTA MONICA BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2305
Mailing Address - Country:US
Mailing Address - Phone:310-453-5557
Mailing Address - Fax:310-828-5536
Practice Address - Street 1:2222 SANTA MONICA BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2305
Practice Address - Country:US
Practice Address - Phone:310-453-5557
Practice Address - Fax:310-828-5536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY395203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy