Lifeline RX Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LIFELINE RX INC

Practice address

6005 Vineland Ave Ste 102
North Hollywood, CA 91606-4985

Phone

(800) 920-5030

Fax

(818) 210-0098

NPI assigned

Aug 9, 2024

Organization subpart

No

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

Authorized official

Name

Polina Oganesyan

Title

President/Ceo

Phone

(800) 920-5030

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• LIFELINE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1801627062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 VINELAND AVE STE 102",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064985",
            "telephone_number": "800-920-5030",
            "fax_number": "818-210-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 VINELAND AVE STE 102",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064985",
            "telephone_number": "800-920-5030",
            "fax_number": "818-210-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE RX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "OGANESYAN",
        "authorized_official_first_name": "POLINA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "800-920-5030"
    },
    "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": "PHY59549",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFELINE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.