Crenshaw Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY55990 Issued in CA

Legal business name

CRENSHAW PHARMACY INC

Practice address

3631 Crenshaw Blvd
Ste 111
Los Angeles, CA 90016-4869

Phone

(323) 732-5555

Fax

(323) 734-5555

NPI assigned

Jan 14, 2015

Last updated

Mar 30, 2022By 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

Dr. Ardalan Behel, RPHNPI 1043634736

Title

Ceo

Phone

(310) 402-7318

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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.

• Ardalan Behel

  • Pharmacist
  • Los Angeles, CA
  • NPI 1043634736
  NPD Authorized official

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1417346305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 CRENSHAW BLVD STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164869",
            "telephone_number": "323-732-5555",
            "fax_number": "323-734-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3631 CRENSHAW BLVD",
            "address_2": "STE 111",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164869",
            "telephone_number": "323-732-5555",
            "fax_number": "323-734-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRENSHAW PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "BEHEL",
        "authorized_official_first_name": "ARDALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-402-7318",
        "authorized_official_name_prefix": "Dr.",
        "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": "54248",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY55990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417346305",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crenshaw Community Center LLC (Crenshaw Community Center)
• Crenshaw Dental Group
• Crenshaw Entrepreneurial Academy
• Crenshaw Family Medical Center, Inc
• Crenshaw Nursing Home LLC (Crenshaw Nursing Home)
• Crenshaw Pharmcare Inc (Stocker RX Pharmacy)
• Crenshaw West Adams Leimert Consortiem (Families In New Directions)
• Kaira Crenshaw, OTR/L
• Keianna Crenshaw
• Nicole T Crenshaw

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, 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 Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.