Mishnik Pharmacy Services Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY48911 Issued in CA

Legal business name

MISHNIK PHARMACY SERVICES INC

Doing business as

Golden Life Pharmacy

Practice address

1960 Sequoia Ave Ste 5
Simi Valley, CA 93063-3176

Phone

(805) 416-8700

Fax

(805) 416-8902

NPI assigned

Nov 21, 2005

Organization subpart

No

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

Authorized official

Name

Amgad Masih, PHARM-D

Title

President

Phone

(805) 416-8700

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• GOLDEN LIFE PHARMACY Doing business as

Tax ID family

Golden Life 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.

• Mishnik Pharmacy Services, Inc.

  • Community/Retail Pharmacy
  • Simi Valley, CA
  • NPI 1053671800
  NPD tax ID

Locations

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1275516502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 SEQUOIA AVE STE 5",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633176",
            "telephone_number": "805-416-8700",
            "fax_number": "805-416-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 SEQUOIA AVE STE 5",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930633176",
            "telephone_number": "805-416-8700",
            "fax_number": "805-416-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHNIK PHARMACY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "MASIH",
        "authorized_official_first_name": "AMGAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-416-8700",
        "authorized_official_credential": "PHARM-D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY48911",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2004406",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9972740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GOLDEN LIFE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shawn Lauritz Miller Sr., OWNER
• Briana Lee Mills
• Miracle Medical
• Nilofar Mirchi
• Alexander Mirras
• Mishnik Pharmacy Services, Inc.
• Mishra Dental Corporation (Sequoia Dentistry)
• Diane Turini Mize, MFT
• Nvard Mkrtchyan
• Carol Mo

• Long Term Care Pharmacy in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.