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NPI Code Detail

MEDICARE: AYN PHARMACY CORP

MEDICARE: AYN PHARMACY CORP
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
1333600000XPharmacyPHY41455CA
23336C0004XCompounding PharmacyPHY41455CA
33336C0003XCommunity/Retail PharmacyPHY41455CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10557112OTHERNABP
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851450944
Entity Type Code : Organization
Provider Name (Legal Business Name) : AYN PHARMACY CORP
Provider Business Mailing Address
First Line : 9730 WILSHIRE BLVD
Second Line : SUITE 103 & 114
City : BEVERLY HILLS
State : CA
Zip : 90212-2022
Country : US
Telephone Number : 310-274-7113
Fax Number : 310-274-2569
Provider Business Practice Location Address
First Line : 9730 WILSHIRE BLVD
Second Line : SUITE 103 & 114
City : BEVERLY HILLS
State : CA
Zip : 90212-2022
Country : US
Telephone Number : 310-274-7113
Fax Number : 310-274-2569
Authorized Official
Title or Position : VICE PRESIDENT
Name : DR. PAYAM NASSIR
Credential : PHARM.D.
Telephone Number : 310-274-7113
Provider Enumeration Date : 12/06/2006
Last Update Date : 09/06/2011

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Directions to “AYN PHARMACY CORP ” Practice Location

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