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General NPI Number Information
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NPI Number | 1962364463
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Entity Type | Organization
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Legal Business Name | MED DEPOT, INC
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 410 N VARNEY ST
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City | BURBANK
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State | CA
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Zip | 91502-1732
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Country | US
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Telephone | 818-903-1897
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Fax |
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Provider Business Mailing Address
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Address Line | 11613 CHARISMA CT
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City | SANTA ROSA VALLEY
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State | CA
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Zip | 93012-8266
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Country | US
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Telephone | 818-903-1897
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT B SARIN-GULIAN
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Credential | PHARMD
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Telephone | 818-903-1897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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