Healthcare Provider Details

I. General information

NPI: 1174214092
Provider Name (Legal Business Name): IHS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 VAN NUYS BLVD STE B
VAN NUYS CA
91405-2256
US

IV. Provider business mailing address

7227 VAN NUYS BLVD STE B
VAN NUYS CA
91405-2256
US

V. Phone/Fax

Practice location:
  • Phone: 714-714-5020
  • Fax:
Mailing address:
  • Phone: 714-714-5020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FADY TAKLA
Title or Position: OWNER/MANAGER
Credential: RPH
Phone: 323-231-9307