Persons Compounding Pharmacy, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PHY57442 Issued in CA

Legal business name

PERSONS COMPOUNDING PHARMACY, INC.

Doing business as

Persons Compounding Pharmacy

Practice address

812 N Glendale Ave
Glendale, CA 91206

Phone

(818) 243-3144

Fax

(818) 243-2171

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Miss Nadia Simantov, PHARMACIST

Title

Cfo Pic

Phone

(818) 243-3144

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PERSONS COMPOUNDING PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881729887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-243-3144",
            "fax_number": "818-243-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91206",
            "telephone_number": "818-243-3144",
            "fax_number": "818-243-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONS COMPOUNDING PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMANTOV",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "CFO PIC",
        "authorized_official_telephone_number": "818-243-3144",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "PHY57442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "0523983",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHY154930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PERSONS COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacist in Glendale, CA
• Providers in Glendale, CA by specialty
• Pharmacist in California

• 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.