Healthcare Provider Details

I. General information

NPI: 1356735369
Provider Name (Legal Business Name): MEDEX PHARMACIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8441 FOOTHILL BOULVARD
SUNLAND CA
91040
US

IV. Provider business mailing address

8441 FOOTHILL BOULVARD
SUNLAND CA
91040
US

V. Phone/Fax

Practice location:
  • Phone: 818-925-1321
  • Fax: 818-446-2241
Mailing address:
  • Phone: 818-925-1321
  • Fax: 818-446-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number52069
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. KARINA KESHISHIAN
Title or Position: CEO/PRESIDENT/PIC
Credential: PHARM D
Phone: 818-648-4477