Provider Demographics
NPI:1356735369
Name:MEDEX PHARMACIES CORP
Entity type:Organization
Organization Name:MEDEX PHARMACIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:818-648-4477
Mailing Address - Street 1:8441 FOOTHILL BOULVARD
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040
Mailing Address - Country:US
Mailing Address - Phone:818-925-1321
Mailing Address - Fax:818-446-2241
Practice Address - Street 1:8441 FOOTHILL BOULVARD
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040
Practice Address - Country:US
Practice Address - Phone:818-925-1321
Practice Address - Fax:818-446-2241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
CA520693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7591710001Medicare NSC