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Organization
VINE DISCOUNT PHARMACY & MEDICAL SUPPLY
Active
Organization
VINE DISCOUNT PHARMACY & MEDICAL SUPPLY
Active
Other names
Vine Discount Pharmacy & Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSEANNE PAPOYAN PHARM.D. (PHARMACIST-IN-CHARGE)
(323) 957-9446
Entity
Organization
Contact information
Practice address
1253 N VINE ST, STE 11, LOS ANGELES, CA 90038-1662
(323) 957-9446
(323) 957-9846
Mailing address
1253 N VINE ST, SUITE #11, LOS ANGELES, CA 90038-1662
(323) 957-9446
(323) 957-9846
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46506
CA
3336S0011X
Specialty Pharmacy
46506
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54097
PHARMACIST-IN-CHARGE LIC#
CA
01
—
5607489
NCPDP
CA
05
—
PHA465060
—
CA
01
—
PHY46506
SITE PERMIT
CA
Enumeration date
05/23/2005
Last updated
04/22/2025
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