Provider Demographics
NPI:1174214092
Name:IHS PHARMACY LLC
Entity type:Organization
Organization Name:IHS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FADY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:323-231-9307
Mailing Address - Street 1:7227 VAN NUYS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2256
Mailing Address - Country:US
Mailing Address - Phone:714-714-5020
Mailing Address - Fax:
Practice Address - Street 1:7227 VAN NUYS BLVD STE B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2256
Practice Address - Country:US
Practice Address - Phone:714-714-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy