Boulevard Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BOULEVARD PHARMACY INC

Doing business as

Olympic Boulevard Pharmacy

Practice address

8950 W Olympic Blvd Ste 103&104
Beverly Hills, CA 90211-3561

Phone

(310) 274-8080

Fax

(310) 274-6876

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Murad Grigoryan

Title

President/Ceo

Phone

(310) 274-8080

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• OLYMPIC BOULEVARD PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 6

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

• Souren Basmadjian, RPH

  • Pharmacist
  • Lancaster, CA
  • NPI 1689943623
  NPD
• Nilofar Behmanesh

  • Pharmacist
  • Beverly Hills, CA
  • NPI 1144795600
  NPD (past)
• Vida Afshani Hakimfar, PHARM D

  • Pharmacist
  • Beverly Hills, CA
  • NPI 1588908602
  NPD (past)
• Susan Virginia Massey

  • Surgical Oncology Physician
  • Beverly Hills, CA
  • NPI 1619486644
  NPD (past)
• Ann Park

  • Pharmacist
  • Beverly Hills, CA
  • NPI 1447919451
  NPD (past)
• Susan V Massey, A.N.P.

  • Nurse Practitioner
  • New York, NY
  • NPI 1962731240
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1871692822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8950 W OLYMPIC BLVD STE 103&104",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113561",
            "telephone_number": "310-274-8080",
            "fax_number": "310-274-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 W OLYMPIC BLVD STE 103&104",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113561",
            "telephone_number": "310-274-8080",
            "fax_number": "310-274-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "GRIGORYAN",
        "authorized_official_first_name": "MURAD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "310-274-8080"
    },
    "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": "PHY58821",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLYMPIC BOULEVARD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael D. Borookhim, M.D.
• Richard Furman Borst, M.D.
• Shiva Hedvat Borukhim, D.D.S.
• Judilin Bosita
• Boulevard Pharmacy Inc
• Jeffrey Bourg, AMFT
• Julie Katherine Bourque, RN, BSN
• Bowman Medical Center for TMS, Inc (TMS Center of Beverly Hills)
• Bowman Psychiatric, a Medical Corporation (Bowman Medical Group)
• Phillip James Bowman, M.D.

• Community/Retail Pharmacy in Beverly Hills, CA
• Providers in Beverly Hills, 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 Dec 13, 2022; 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.