Organization Active NPI

Recovery Pharmaceuticals Inc

Doing business as Knollwood Pharmacy

  • Community/Retail Pharmacy
  • Granada Hills, CA
National Provider Identifier
1255342747
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY47109 Issued in CA
Legal business name
RECOVERY PHARMACEUTICALS INC
Doing business as
Knollwood Pharmacy
Practice address
16911 San Fernando Mission Blvd
Granada Hills, CA 91344
Phone
(818) 363-8107
Fax
(818) 831-2024
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Authorized official

Name
Milad Tossoun, RPHNPI 1730511619
Title
President, Pic
Phone
(818) 363-8107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY47109 CA Primary

Addresses

Primary practice location

16911 San Fernando Mission Blvd
Granada Hills, CA 91344

Mailing address

16911 San Fernando Mission Blvd
Granada Hills, CA 91344-4250
Phone (818) 363-8107

Other identifiers 2

IdentifierTypeStateIssuer
1255342747OtherCANPI
PHA344990MedicaidCA

Other names 1

  • Knollwood Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110222001193 CA Part B Supplier - Mass Immunization (Roster Biller Only) 5193936797 Practice locations: Granada Hills, CA

National Provider Directory

National Provider Directory

Locations

11862 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 363-8107

16911 San Fernando Mission Blvd
Granada Hills, CA 91344
Phone (818) 363-8107

Practitioners & affiliated clinicians

Practitioners 2

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1255342747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16911 SAN FERNANDO MISSION BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444250",
            "telephone_number": "818-363-8107",
            "fax_number": "818-831-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16911 SAN FERNANDO MISSION BLVD",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "91344",
            "telephone_number": "818-363-8107",
            "fax_number": "818-831-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY PHARMACEUTICALS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "TOSSOUN",
        "authorized_official_first_name": "MILAD",
        "authorized_official_title_or_position": "PRESIDENT, PIC",
        "authorized_official_telephone_number": "818-363-8107",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1255342747",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA344990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knollwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.