Prime Liberty Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PRIME LIBERTY PHARMACY INC

Doing business as

Prime Liberty Pharmacy

Practice address

7335 Van Nuys Blvd Ste 107
Van Nuys, CA 91405-1951

Phone

(818) 465-3515

Fax

(818) 465-3514

NPI assigned

Mar 7, 2019

Last updated

Jul 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hasmik Gevshenian

Title

Ceo/Cfo/Sec/Dir

Phone

(818) 465-3515

Specialties & licenses 3

Addresses

Other names 1

• PRIME LIBERTY PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diana Moskovyan

  • Pharmacist
  • Van Nuys, CA
  • NPI 1912364514
  NPD

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1275091373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7335 VAN NUYS BLVD STE 107",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051951",
            "telephone_number": "818-465-3515",
            "fax_number": "818-465-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7335 VAN NUYS BLVD STE 107",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051951",
            "telephone_number": "818-465-3515",
            "fax_number": "818-465-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME LIBERTY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "GEVSHENIAN",
        "authorized_official_first_name": "HASMIK",
        "authorized_official_title_or_position": "CEO/CFO/SEC/DIR",
        "authorized_official_telephone_number": "818-465-3515"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIME LIBERTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prime 1 Home Health
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• Prime Dent Laboratory, LLC.
• Prime Med Laboratory Inc
• Prime Palliative Care Inc
• Prime Plus Hospice Inc
• Prime Van Nuys Homecare, Inc.
• Prime Van Nuys Hospice, Inc.

• Community/Retail Pharmacy in Van Nuys, CA
• Providers in Van Nuys, 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 Jul 15, 2021; 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.