Select LTC Pharmacy Corporation

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

SELECT LTC PHARMACY CORPORATION

Doing business as

SELECT LTC PHARMACY

Practice address

11203 S la Cienega Blvd
Los Angeles, CA 90045-6112

Phone

(310) 341-3455

Fax

(310) 341-3454

NPI assigned

Feb 4, 2021

Organization subpart

No

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

Authorized official

Name

Ellina Chulpaeff

Title

President/Ceo

Phone

(310) 341-3455

Specialties & licenses 1

Addresses

Other names 1

• SELECT LTC PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Select LTC Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Select LTC Pharmacy Corporation

  • Long Term Care Pharmacy
  • Riverside, CA
  • NPI 1164285110
  NPD tax ID

Locations

Practitioners 1

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

• Julia X Rutkouskaya, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1790413888
  NPD

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1760074579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11203 S LA CIENEGA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456112",
            "telephone_number": "310-341-3455",
            "fax_number": "310-341-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11203 S LA CIENEGA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456112",
            "telephone_number": "310-341-3455",
            "fax_number": "310-341-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT LTC PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "CHULPAEFF",
        "authorized_official_first_name": "ELLINA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "310-341-3455"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELECT LTC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.