Poly-Med Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

55979 Issued in CA

Legal business name

POLY-MED PHARMACY INC

Practice address

17313 Roscoe Blvd
Northridge, CA 91325

Phone

(747) 235-3535

NPI assigned

Mar 16, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Liana Minasyan

Title

Owner/Pic

Phone

(747) 235-3535

Specialties & licenses 1

Addresses

Other names 1

• POLY-MED PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

Poly-Med Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Poly-Med Pharmacy Inc

  • Long Term Care Pharmacy
  • Northridge, CA
  • NPI 1851098412
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521158400000",
    "number": "1043713969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17313 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17313 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91325",
            "telephone_number": "747-235-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLY-MED PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-16",
        "last_updated": "2018-03-16",
        "status": "A",
        "authorized_official_last_name": "MINASYAN",
        "authorized_official_first_name": "LIANA",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "747-235-3535"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POLY-MED PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Desantis Plescia
• PNH Hospice Group
• Delia G Poblete
• John Pola
• Chanel Rae Pollard
• Poly-Med Pharmacy Inc
• Angela Ponce
• Maria Irene Ponce, MSW, ACSW
• Christine Popaj, LMFT
• Michelle Porciuncula

• Community/Retail Pharmacy in Northridge, CA
• Providers in Northridge, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.