Healthcare Provider Details

I. General information

NPI: 1881633782
Provider Name (Legal Business Name): PHARMEDIX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S LAKE AVE
PASADENA CA
91101-3511
US

IV. Provider business mailing address

555 S LAKE AVE
PASADENA CA
91101-3511
US

V. Phone/Fax

Practice location:
  • Phone: 626-792-3156
  • Fax: 626-792-8556
Mailing address:
  • Phone: 626-792-3156
  • Fax: 626-792-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY46502
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY46502
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberPHY46502
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License NumberPHY46502
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License NumberPHY46502
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHY46502
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberPHY46502
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY46502
License Number StateCA

VIII. Authorized Official

Name: BISI ALAGBE
Title or Position: PRESIDENT
Credential:
Phone: 626-792-3156