Innova RX Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

56074 Issued in CA

Legal business name

INNOVA RX INC.

Practice address

8737 Beverly Blvd Ste 102
West Hollywood, CA 90048-1835

Phone

(424) 303-7860

Fax

(424) 303-7854

NPI assigned

Feb 23, 2018

Organization subpart

No

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

Authorized official

Name

Siamak Bagheri

Title

Ceo/Owner

Phone

(424) 303-7860

Specialties & licenses 1

Addresses

Other names 1

• Cedarmak Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• RX Biotech Pharmacy LLC

  • Specialty Pharmacy
  • Burbank, CA
  • NPI 1144457078

  O20130401000256

  Same enrollment

Locations

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519344000000",
    "number": "1477054567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8737 BEVERLY BLVD STE 102",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481835",
            "telephone_number": "424-303-7860",
            "fax_number": "424-303-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8737 BEVERLY BLVD STE 102",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481835",
            "telephone_number": "424-303-7860",
            "fax_number": "424-303-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA RX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A",
        "authorized_official_last_name": "BAGHERI",
        "authorized_official_first_name": "SIAMAK",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "424-303-7860"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "56074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedarmak Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Eing Imada, PHARMD
• Crystal Imankhan, OD
• Ryan Michael Ingram, PSYD
• Eno Elizabeth Inikori, MD
• Patil Injean, DO
• Insight Choices Community Wellness PC
• Insight Choices Community, Inc.
• Yevgeniya Jane Mikhailovna Ioffe, M.D.
• Stephen L Isaacman, PSYD.
• Michelle Levian Ischayek, D.O.

• Community/Retail Pharmacy in West Hollywood, CA
• Providers in West Hollywood, 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 Feb 23, 2018; 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.