Organization Active NPI

Star Pharmacy

  • Nursing Facility Supplies (DME)
  • Van Nuys, CA
National Provider Identifier
1669419917
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility Supplies (DME)Taxonomy code 332BN1400X
License
PHY42197 Issued in CA
Legal business name
STAR PHARMACY
Practice address
14400 Vanowen St
Van Nuys, CA 91405-4037
Phone
(818) 304-0881
Fax
(818) 304-0882
NPI assigned
Jun 2, 2006
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
Anthony A Luskin
Title
President
Phone
(818) 304-0881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility Supplies (DME) 332BN1400X PHY42197 CA Primary

Addresses

Primary practice location

14400 Vanowen St
Van Nuys, CA 91405-4037

Mailing address

14400 Vanowen St
Van Nuys, CA 91405-4037
Phone (818) 304-0881

Other identifiers 1

IdentifierTypeStateIssuer
PHAY21970MedicaidCA

National Provider Directory

National Provider Directory

Locations

14400 Vanowen St
Van Nuys, CA 91405
Phone (818) 304-0881

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669419917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054037",
            "telephone_number": "818-304-0881",
            "fax_number": "818-304-0882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914054037",
            "telephone_number": "818-304-0881",
            "fax_number": "818-304-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUSKIN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-304-0881"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "CA",
            "license": "PHY42197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHAY21970",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, 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.