Healthcare Provider Details

I. General information

NPI: 1184081515
Provider Name (Legal Business Name): HEP PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 09/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W GLENOAKS BLVD SUITE G
GLENDALE CA
91202-2663
US

IV. Provider business mailing address

900 W GLENOAKS BLVD SUITE G
GLENDALE CA
91202-2663
US

V. Phone/Fax

Practice location:
  • Phone: 818-649-1772
  • Fax:
Mailing address:
  • Phone: 818-945-5799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number53889
License Number StateCA

VIII. Authorized Official

Name: NANCY SIMONIAN
Title or Position: CEO
Credential:
Phone: 818-261-8023