Organization Active NPI

Varda Samboul

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1093874844
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
VARDA SAMBOUL
Practice address
2922 Division St
Los Angeles, CA 90065-1233
Phone
(323) 222-7982
Fax
(323) 222-3207
NPI assigned
Dec 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Ms. Varda Samboul
Title
Owner
Phone
(323) 222-7982

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2922 Division St
Los Angeles, CA 90065-1233

Mailing address

2922 Division St
Los Angeles, CA 90065-1233
Phone (323) 222-7982

Other identifiers 1

IdentifierTypeStateIssuer
PHY434970MedicaidCA

Other names 1

  • S&S PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

2922 Division St
Los Angeles, CA 90065
Phone (323) 222-7982

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1093874844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 DIVISION ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900651233",
            "telephone_number": "323-222-7982",
            "fax_number": "323-222-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 DIVISION ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900651233",
            "telephone_number": "323-222-7982",
            "fax_number": "323-222-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARDA SAMBOUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "SAMBOUL",
        "authorized_official_first_name": "VARDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-222-7982",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY434970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S&S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "S&S PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.