MEDICARE: FARMA PHARMACEUTICALS, 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
1	3336C0004X	Compounding Pharmacy	PHY51979	CA
2	3336C0003X	Community/Retail Pharmacy	PHY51979	CA

General Provider Information

NPI Number	:	1407244585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARMA PHARMACEUTICALS, INC.

Provider Business Mailing Address
First Line	:	5240 SAN FERNANDO RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-2439
Country	:	US
Telephone Number	:	818-638-3113
Fax Number	:	213-270-9384

Provider Business Practice Location Address
First Line	:	5240 SAN FERNANDO RD
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-2439
Country	:	US
Telephone Number	:	818-464-5655
Fax Number	:	213-270-9384

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STEPHEN COBOS
Credential	:
Telephone Number	:	818-464-5655

Provider Enumeration Date	:	12/24/2014
Last Update Date	:	10/09/2015

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