Provider Demographics
NPI:1275340978
Name:IM PHARMACY INC
Entity type:Organization
Organization Name:IM PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINOV
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-847-8600
Mailing Address - Street 1:10970 SHERMAN WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1003
Mailing Address - Country:US
Mailing Address - Phone:818-847-8600
Mailing Address - Fax:818-847-8698
Practice Address - Street 1:10970 SHERMAN WAY STE 110
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1003
Practice Address - Country:US
Practice Address - Phone:818-847-8600
Practice Address - Fax:818-847-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty