Active NPI
Im Pharmacy Inc
- Community/Retail Pharmacy
- Burbank, CA
National Provider Identifier
1528298064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY51128
- Legal business name
- IM PHARMACY INC
- Practice address
- 10970 Sherman Way Ste 110
Burbank, CA 91505-1003 - Phone
- (818) 847-8600
- Fax
- (818) 847-8698
- NPI assigned
- Jul 17, 2009
- 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
- Mr. Igor Martinov
- Title
- President/Pic
- Phone
- (818) 335-4000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHY51128 | CA | |
| Community/Retail Pharmacy | 3336C0003X | PHY51128 | CA | Primary |
Addresses
Primary practice location
10970 Sherman Way Ste 110
Burbank, CA 91505-1003
Mailing address
10970 Sherman Way
Suite 110
Burbank, CA 91505-1002
Phone (818) 847-8600
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51128 | Other | CA | RETAIL PHARMACY PERMIT |
| 5635012 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- KD Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Im Pharmacy Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacist
- Burbank, CA
- NPI 1275340978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247788800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1355443200000",
"number": "1528298064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10970 SHERMAN WAY",
"address_2": "SUITE 110",
"city": "BURBANK",
"state": "CA",
"postal_code": "915051002",
"telephone_number": "818-847-8600",
"fax_number": "818-847-8698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10970 SHERMAN WAY STE 110",
"city": "BURBANK",
"state": "CA",
"postal_code": "915051003",
"telephone_number": "818-847-8600",
"fax_number": "818-847-8698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IM PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-07-17",
"last_updated": "2012-12-14",
"status": "A",
"authorized_official_last_name": "MARTINOV",
"authorized_official_first_name": "IGOR",
"authorized_official_title_or_position": "PRESIDENT/PIC",
"authorized_official_telephone_number": "818-335-4000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CA",
"license": "PHY51128",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY51128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RETAIL PHARMACY PERMIT",
"identifier": "51128",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "5635012",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "KD Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.