Provider Demographics
NPI:1356713390
Name:WESTCLIFF PHARMACY INC
Entity type:Organization
Organization Name:WESTCLIFF PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SISLYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-350-3800
Mailing Address - Street 1:PO BOX 2240
Mailing Address - Street 2:
Mailing Address - City:TOLUCA LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:91610-0240
Mailing Address - Country:US
Mailing Address - Phone:212-350-3800
Mailing Address - Fax:212-350-3838
Practice Address - Street 1:896 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-8008
Practice Address - Country:US
Practice Address - Phone:212-350-3800
Practice Address - Fax:212-350-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157694OtherPK