MEDICARE: SUNLAND PHARMACY INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY54345	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2160401	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467808683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNLAND PHARMACY INCORPORATED

Provider Business Mailing Address
First Line	:	8422 SUNLAND BLVD
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3436
Country	:	US
Telephone Number	:	818-962-3851
Fax Number	:	818-962-3850

Provider Business Practice Location Address
First Line	:	8422 SUNLAND BLVD
Second Line	:
City	:	SUN VALLEY
State	:	CA
Zip	:	91352-3436
Country	:	US
Telephone Number	:	818-962-3851
Fax Number	:	818-962-3850

Authorized Official
Title or Position	:	OWNER/CEO/PIC
Name	:	LUSINE SARGSYAN
Credential	:	PHARM D
Telephone Number	:	818-962-3851

Provider Enumeration Date	:	05/06/2016
Last Update Date	:	04/12/2022

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Directions to “SUNLAND PHARMACY INCORPORATED ” Practice Location

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