Healthcare Provider Details

I. General information

NPI: 1083607212
Provider Name (Legal Business Name): HYE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5236 SANTA MONICA BLVD
LOS ANGELES CA
90029-1210
US

IV. Provider business mailing address

5236 SANTA MONICA BLVD
LOS ANGELES CA
90029-1210
US

V. Phone/Fax

Practice location:
  • Phone: 323-661-7152
  • Fax: 323-661-7269
Mailing address:
  • Phone: 323-661-7152
  • Fax: 323-661-7269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHY32762
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. PETROS TAGLYAN
Title or Position: PRESIDENT/PHARMACIST
Credential: PHARM D
Phone: 323-661-7152