Organization Active NPI

L.a. Nova Pharmacy Inc.

  • Pharmacist
  • Pasadena, CA
National Provider Identifier
1114052891
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHY44112 Issued in CA
Legal business name
L.A. NOVA PHARMACY INC.
Doing business as
Nova Pharmacy
Practice address
290 N Hill Ave Ste 4
Pasadena, CA 91106-1563
Phone
(626) 583-8786
Fax
(626) 583-8212
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Armen Pogossian
Title
Ceo
Phone
(626) 583-8786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PHY44112 CA Primary

Addresses

Primary practice location

290 N Hill Ave Ste 4
Pasadena, CA 91106-1563

Mailing address

290 N Hill Ave Ste 4
Pasadena, CA 91106-1563
Phone (626) 583-8786

Other identifiers 1

IdentifierTypeStateIssuer
PHA441120MedicaidCA

Other names 1

  • Nova Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

290 N Hill Ave
Ste 4
Pasadena, CA 91106
Phone (626) 583-8786

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": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114052891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 N HILL AVE STE 4",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061563",
            "telephone_number": "626-583-8786",
            "fax_number": "626-583-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 N HILL AVE STE 4",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061563",
            "telephone_number": "626-583-8786",
            "fax_number": "626-583-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L.A. NOVA PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POGOSSIAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-583-8786",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY44112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA441120",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nova Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.