1053321703 NPI number — TORGSYN DISCOUNT PHARMACY, INC

Table of content: (NPI 1053321703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053321703 NPI number — TORGSYN DISCOUNT PHARMACY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TORGSYN DISCOUNT PHARMACY, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053321703
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5614 GEARY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94121-2215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-752-3737
Provider Business Mailing Address Fax Number:
415-752-3730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5614 GEARY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94121-2215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-752-3737
Provider Business Practice Location Address Fax Number:
415-752-3730
Provider Enumeration Date:
08/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VARTANIAN
Authorized Official First Name:
NARINE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRES, CEO
Authorized Official Telephone Number:
415-752-3737

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  332B00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 3336C0003X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PHA414900 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".