Vertexrx Pharmacy Incorporated

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VERTEXRX PHARMACY INCORPORATED

Practice address

11273 Laurel Canyon Blvd Ste 4
San Fernando, CA 91340-4359

Phone

(818) 638-9652

Fax

(818) 638-9653

NPI assigned

Jan 7, 2020

Organization subpart

No

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

Authorized official

Name

Angel Samvalian

Title

Ceo

Phone

(818) 638-9652

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• VertexRx Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1922648948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11273 LAUREL CANYON BLVD STE 4",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404359",
            "telephone_number": "818-638-9652",
            "fax_number": "818-638-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11273 LAUREL CANYON BLVD STE 4",
            "city": "SAN FERNANDO",
            "state": "CA",
            "postal_code": "913404359",
            "telephone_number": "818-638-9652",
            "fax_number": "818-638-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERTEXRX PHARMACY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "SAMVALIAN",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-638-9652"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9307542",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VertexRx Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesus Miguel Venegas, DC
• Paola Ventura
• Marie Verdugo
• Vertex Care RX Inc
• Vertex Care RX Inc
• Vesta Home Health Care
• Nicholas James Vetter, L.M.F.T.
• Miguel Angel Victoria
• Vida Community Clinic
• Vikramkumar H Shah D.D.S Inc

• Community/Retail Pharmacy in San Fernando, CA
• Providers in San Fernando, 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 20, 2021; 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.