NPIMap

Organization Active NPI

Medallion Prescription Pharmacy

  • Pharmacy
  • West Hills, CA
National Provider Identifier
1649267626
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
PHY394090 Issued in CA
Legal business name
MEDALLION PRESCRIPTION PHARMACY
Practice address
23101 Sherman PL
Suite #101
West Hills, CA 91307-2008
Phone
(818) 789-6836
Fax
(818) 340-5075
NPI assigned
Oct 4, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Beatrisa Tseytlin, PHARMDNPI 1437146313
Title
Pharmacist
Phone
(818) 340-0212

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X PHY394090 CA Primary

Addresses

Primary practice location

23101 Sherman PL
Suite #101
West Hills, CA 91307-2008

Mailing address

23101 Sherman PL
Suite #101
West Hills, CA 91307-2008
Phone (818) 789-6836

Other identifiers 1

IdentifierTypeStateIssuer
PHA394090MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
McStroul Enterprises Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649267626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23101 SHERMAN PL",
            "address_2": "SUITE #101",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072008",
            "telephone_number": "818-789-6836",
            "fax_number": "818-340-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23101 SHERMAN PL",
            "address_2": "SUITE #101",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913072008",
            "telephone_number": "818-789-6836",
            "fax_number": "818-340-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDALLION PRESCRIPTION PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TSEYTLIN",
        "authorized_official_first_name": "BEATRISA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "818-340-0212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY394090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA394090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.