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NPI Code Detail

MEDICARE: DORAN PHARMACY INC.

MEDICARE: DORAN PHARMACY INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376955781
Entity Type Code : Organization
Provider Name (Legal Business Name) : DORAN PHARMACY INC.
Provider Business Mailing Address
First Line : 525 N GLENDALE AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91206-3307
Country : US
Telephone Number : 818-331-2932
Fax Number :
Provider Business Practice Location Address
First Line : 525 N GLENDALE AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91206-3307
Country : US
Telephone Number : 818-291-4099
Fax Number : 818-291-4097
Authorized Official
Title or Position : PRESIDENT
Name : MS. SUSANNA KESHISHIAN
Credential : PHARM.D.
Telephone Number : 818-331-2932
Provider Enumeration Date : 05/20/2014
Last Update Date : 02/08/2022

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