Health Source Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HEALTH SOURCE PHARMACY, LLC

Practice address

7012 Reseda Blvd.
Ste. a - 1
Reseda, CA 91335-4219

Phone

(866) 447-7317

Fax

(877) 209-9150

NPI assigned

Jul 15, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Ramtin Ghavami, PHARMACIST IN CHARGENPI 1497184113

Title

Owner

Phone

(949) 613-6495

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ramtin Ghavami

  • Pharmacist
  • Corona, CA
  • NPI 1497184113
  NPD (past) Authorized official

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1477937852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 RESEDA BLVD.",
            "address_2": "STE. A - 1",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354219",
            "telephone_number": "866-447-7317",
            "fax_number": "877-209-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 RESEDA BLVD.",
            "address_2": "STE. A - 1",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913354219",
            "telephone_number": "866-447-7317",
            "fax_number": "877-209-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SOURCE PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "GHAVAMI",
        "authorized_official_first_name": "RAMTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-613-6495",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST IN CHARGE"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Reseda, CA
• Providers in Reseda, 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 1, 2017; 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.