Provider Demographics
NPI:1427112887
Name:ALPHA PHARMACY
Entity type:Organization
Organization Name:ALPHA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-N-CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAGLAT
Authorized Official - Middle Name:ZAKY
Authorized Official - Last Name:SEWILAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-772-7475
Mailing Address - Street 1:10231A TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2804
Mailing Address - Country:US
Mailing Address - Phone:818-772-7475
Mailing Address - Fax:818-772-8163
Practice Address - Street 1:10231A TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2804
Practice Address - Country:US
Practice Address - Phone:818-772-7475
Practice Address - Fax:818-772-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY411000Medicaid
CA0525189Medicare UPIN
CA1039320001Medicare ID - Type Unspecified