Provider Demographics
NPI:1184081515
Name:HEP PHARMACY INC
Entity type:Organization
Organization Name:HEP PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-261-8023
Mailing Address - Street 1:900 W GLENOAKS BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2663
Mailing Address - Country:US
Mailing Address - Phone:818-945-5799
Mailing Address - Fax:
Practice Address - Street 1:900 W GLENOAKS BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2663
Practice Address - Country:US
Practice Address - Phone:818-649-1772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53889333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy