Northridge Plaza Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

NORTHRIDGE PLAZA PHARMACY INC.

Practice address

18546 Roscoe Blvd.
#102
Northridge, CA 91324

Phone

(818) 998-8700

Fax

(818) 998-8730

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Carlos Manuel Gomez

Title

Quality & Project Manager

Phone

(305) 740-9720

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• SMP Pharmacy Solutions #4 Doing business as

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ike Dahjet

  • Pharmacist
  • Northridge, CA
  • NPI 1700411055
  NPD
• Iqra Saleem

  • Pharmacist
  • Northridge, CA
  • NPI 1083377956
  NPD

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1457530735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 SW 42ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554402",
            "telephone_number": "305-740-9696",
            "fax_number": "818-998-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18546 ROSCOE BLVD.",
            "address_2": "#102",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-998-8700",
            "fax_number": "818-998-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE PLAZA PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "QUALITY & PROJECT MANAGER",
        "authorized_official_telephone_number": "305-740-9720"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "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": "2066993",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA393410",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "compliance@smppharmacy.com",
            "affiliation": "N",
            "address_1": "18546 Roscoe Blvd.",
            "address_2": "#102",
            "city": "Northridge",
            "state": "CA",
            "country_code": "US",
            "postal_code": "91324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SMP Pharmacy Solutions #4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Northridge Neurological Medical Group Inc
• Northridge Outpatient Surgery Center Inc
• Northridge Pain Management Specialists Medical Corporation
• Northridge Physical Therapy Center,Inc
• Northridge Plaza Medical Supply
• Northridge Surgery Center LLC
• Northridge Trauma Surgeons Inc a Medical Corporation
• Northridge Vascular Center a Professional Medical Corporation
• Northridge Villa for Elderly Inc.
• Nosratullah Khajavi, D.O.

• All providers in Northridge, CA
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.