Active NPI
Doran Pharmacy Inc.
- Community/Retail Pharmacy
- Glendale, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- DORAN PHARMACY INC.
- Practice address
- 525 N Glendale Ave
Glendale, CA 91206-3307 - Phone
- (818) 291-4099
- Fax
- (818) 291-4097
- NPI assigned
- May 20, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Susanna Keshishian, PHARM.D.
- Title
- President
- Phone
- (818) 331-2932
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
525 N Glendale Ave
Glendale, CA 91206-3307
Mailing address
525 N Glendale Ave
Glendale, CA 91206-3307
Phone (818) 331-2932
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CB235284 | Medicaid | CA |
Other names 1
- Doran Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150630002606 | CA | Part B Supplier - Pharmacy | 6507178795 | Practice locations: Glendale, CA |
| O20180208000080 | CA | DME Supplier - Pharmacy | 6507178795 | Practice locations: Glendale, CA |
| O20240206000609 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 6507178795 | Practice locations: Glendale, CA |
National Provider Directory
National Provider Directory- Tax ID family
- Doran Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Glendale, CA
- NPI 1508607300
Locations
525 N Glendale Ave
Glendale, CA 91206
Phone (818) 291-4099
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Glendale, CA
- NPI 1972814796
-
- Pharmacist
- Los Angeles, CA
- NPI 1134777915
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644278400000",
"number": "1376955781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 N GLENDALE AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912063307",
"telephone_number": "818-331-2932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 N GLENDALE AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912063307",
"telephone_number": "818-291-4099",
"fax_number": "818-291-4097"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DORAN PHARMACY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-05-20",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A",
"authorized_official_last_name": "KESHISHIAN",
"authorized_official_first_name": "SUSANNA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "818-331-2932",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CB235284",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Doran Pharmacy",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Doran Pharmacy",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.