CRENSHAW PHARMACY INC (NPI# 1417346305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417346305 |
| Entity Type | Organization |
| Organization Name | CRENSHAW PHARMACY INC |
| Practice Address |
3631 Crenshaw Blvd Ste 111 Los Angeles CA 90016-4869 |
| Mailing Address |
3631 Crenshaw Blvd Ste 111 Los Angeles CA 90016-4869 |
| Practice Telephone | 3237325555 |
| Practice Fax Number | 3237345555 |
| Mailing Telephone | 3237325555 |
| Mailing Fax Number | 3237345555 |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2018-03-22 |
| Authorized Official Name | DR. ARDALAN BEHEL (CEO) |
| Authorized Official Telephone | 3104027318 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
54248 | CA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHY55990 | CA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2152134 | 01 |
| Street Address |
3631 CRENSHAW BLVD STE 111 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90016-4869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477554616 | Kevin A Brown | Family Medicine | 3631 Crenshaw Blvd, #110, Los Angeles, CA 90016-4869 | 2005-08-10 |
| 1437703014 | Arys Dembekjian | Dentist | 3631 Crenshaw Blvd, Los Angeles, CA 90016-4869 | 2019-07-31 |
| 1932568284 | Sabrina Moiseyev | Nurse Practitioner | 3631 Crenshaw Blvd, #109, Los Angeles, CA 90016-4869 | 2016-02-15 |
| 1063836120 | Shary Joseph | Nurse Practitioner | 3631 Crenshaw Blvd, Los Angeles, CA 90016-4869 | 2014-02-10 |
| 1811339799 | Cynthia Lynn Courtney | Nurse Practitioner | 3631 Crenshaw Blvd, 109, Los Angeles, CA 90016-4869 | 2013-07-22 |
| 1063695302 | Boris Berzon Md Inc | Clinic/Center | 3631 Crenshaw Blvd, Ste 102 103, Los Angeles, CA 90016-4869 | 2007-12-10 |
| 1578763207 | Benevolence Industries Incorporated | Clinic/Center | 3631 Crenshaw Blvd, 109, Los Angeles, CA 90016-4869 | 2007-07-20 |
| 1982616793 | Milo M Webber M D, Inc | Specialist | 3631 Crenshaw Blvd, Suite 103, Los Angeles, CA 90016-4869 | 2006-08-12 |
| 1912935842 | Evangeline Gutierrez Bautista | Family Medicine | 3631 Crenshaw Blvd, Suite 109, Los Angeles, CA 90016-4869 | 2006-06-29 |
| 1891730883 | Milo Melvin Webber | Specialist | 3631 Crenshaw Blvd, Suite # 103, Los Angeles, CA 90016-4869 | 2006-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790334134 | Rodef & Yousefi Dental Corporation | Dentist | 3736 Crenshaw Blvd, Los Angeles, CA 90016 | 2019-09-09 |
| 1891278016 | Harold Ringgold Jr. | Counselor | 5220 Washington Ste 101 &104, Los Angeles, CA 90016 | 2018-09-13 |
| 1477085330 | Nyul Aegd | Student in an Organized Health Care Education/Training Program | 3743 S Labrea Avenue, Los Angeles, CA 90016 | 2017-03-30 |
| 1770978876 | Alexander Delacruz Jr. | Nutritionist | 2336 Crenshaw Blvd, Suite 101, Los Angeles, CA 90016 | 2015-04-06 |
| 1518358670 | Henry Bratton | Counselor | 2017 Westview Street, Los Angeles, CA 90016 | 2015-02-11 |
| 1063819084 | Karina Ann Chandler-ziegler | Counselor | 5220 Washington Street, Ste. 101, Los Angeles, CA 90016 | 2014-11-20 |
| 1801299136 | Smith Medical Management | Clinical Medical Laboratory | 2953 Palm Grove Ave, Los Angeles, CA 90016 | 2014-10-01 |
| 1366844144 | No Dorm Inc. | Assisted Living Facility | 5222 Washington Blvd., Los Angeles, CA 90016 | 2014-09-23 |
| 1891120853 | Margaret Yarbrough | General Practice | 3717 S. Labrea, #341, Los Angeles, CA 90016 | 2013-09-10 |
| 1821422346 | Circle of Help Foundation | Community/Behavioral Health | 4701 Rodeo Rd., Room #2, #3, Los Angeles, CA 90016 | 2013-09-03 |
| Find all providers in zip 90016 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265040836 | Cmc Enterprise, Inc. | Pharmacy | 2426 W 8th St Ste 112, Los Angeles, CA 90057-3840 | 2020-07-20 |
| 1538782230 | Altamed Health Services Corp | Pharmacy | 3945 Whittier Blvd Rm 100, Los Angeles, CA 90023-2440 | 2020-05-28 |
| 1184243602 | Dtla Rx Pharmacy Apc | Pharmacy | 1120 S Grand Ave Ste 103, Los Angeles, CA 90015-4677 | 2020-04-14 |
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1649807140 | Mixlab, Inc. | Pharmacy | 2223 Federal Ave, Los Angeles, CA 90064-1403 | 2020-03-25 |
| 1457985426 | Care Prescription Management | Pharmacy | 5757 Wilshire Blvd Ste 320, Los Angeles, CA 90036-3686 | 2020-02-27 |
| 1609409077 | Altamed Health Services Corp | Pharmacy | 2100 W 3rd St Ste 190, Los Angeles, CA 90057-1999 | 2020-02-13 |
| 1003448184 | Linco Pharmacy, Inc. | Pharmacy | 5755 W Adams Blvd, Los Angeles, CA 90016-2440 | 2020-02-06 |
| 1972149292 | Cedars-sinai Medical Care Foundation | Pharmacy | 11800 Wilshire Blvd Ste 202, Los Angeles, CA 90025-6602 | 2019-11-21 |
| 1659930089 | Jade Kalelei Wilia | Pharmacy | 1411 N Mansfield Ave Apt 9, Los Angeles, CA 90028-7676 | 2019-06-10 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90016 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.