=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063893816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | D & A PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2015
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14427 CHASE ST STE 102
-----------------------------------------------------
City | PANORAMA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91402-3020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-810-7554
-----------------------------------------------------
Fax | 818-810-7262
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14427 CHASE ST STE 102
-----------------------------------------------------
City | PANORAMA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91402-3020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-810-7554
-----------------------------------------------------
Fax | 818-810-7262
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | SHERRI A GARDIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-810-7554
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------