Spaulding Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SPAULDING PHARMACY INC

Doing business as

SPAULDING PHARMACY

Practice address

7722 Santa Monica Blvd
West Hollywood, CA 90046-6220

Phone

(323) 656-3663

Fax

(323) 656-3668

NPI assigned

Aug 3, 2005

Organization subpart

No

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

Authorized official

Name

Alexander KonopovNPI 1326257031

Title

President/Ceo/Secretary/Dir

Phone

(323) 656-3663

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• SPAULDING PHARMACY Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 3

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

• Alexander Konopov, PHARMACY TECH

  • Pharmacy Technician
  • West Hollywood, CA
  • NPI 1326257031
  NPD Authorized official
• Stacy Hae Sin Kim, PHARMACIST

  • Pharmacist
  • West Hollywood, CA
  • NPI 1932318680
  NPD (past)
• Gennady Mazin, PHARMACY TECH

  • Pharmacy Technician
  • West Hollywood, CA
  • NPI 1427267111
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1962403568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900466220",
            "telephone_number": "323-656-3663",
            "fax_number": "323-656-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7722 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900466220",
            "telephone_number": "323-656-3663",
            "fax_number": "323-656-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPAULDING PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "KONOPOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT/CEO/SECRETARY/DIR",
        "authorized_official_telephone_number": "323-656-3663"
    },
    "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": "PHY59124",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPAULDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in West Hollywood, CA
• Providers in West 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 Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.