Organization Active NPI

Shalom RX Inc

Doing business as Shalom Pharmacy

  • Community/Retail Pharmacy
  • Encino, CA
National Provider Identifier
1770797847
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SHALOM RX INC
Doing business as
Shalom Pharmacy
Practice address
18000 Ventura Blvd Ste 2
Encino, CA 91316-3533
Phone
(818) 774-1800
Fax
(818) 774-1188
NPI assigned
May 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Authorized official

Name
Babak Kohanchi, PHARM DNPI 1598983157
Title
President/Ceo
Phone
(818) 774-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

18000 Ventura Blvd Ste 2
Encino, CA 91316-3533

Mailing address

18000 Ventura Blvd Ste 2
Encino, CA 91316-3533
Phone (818) 774-1800

Other identifiers 1

IdentifierTypeStateIssuer
PHY58843OtherCABOARD OF PHARMACY

Other names 1

  • SHALOM PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240119001307 CA DME Supplier - Pharmacy 5597117127 Practice locations: Encino, CA

National Provider Directory

National Provider Directory

Locations

18000 Ventura Blvd
Ste 2
Encino, CA 91316
Phone (818) 774-1800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1770797847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 VENTURA BLVD STE 2",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163533",
            "telephone_number": "818-774-1800",
            "fax_number": "818-774-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18000 VENTURA BLVD STE 2",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163533",
            "telephone_number": "818-774-1800",
            "fax_number": "818-774-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "KOHANCHI",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-774-1800",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY58843",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHALOM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.