Organization
SATELITTE MEDICATION DISPENSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGEY SARKISOFF PHARMD (PHARMACIST)
(818) 409-8521
Entity
Organization
Contact information
Practice address
1509 WILSON TER # 4B13, GLENDALE, CA 91206-4007
(818) 409-8521
Mailing address
1509 WILSON TER # 4B13, GLENDALE, CA 91206-4007
(818) 409-8521
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
69067
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69067
STATE LICENSE NUMBER
CA
Enumeration date
10/26/2016
Last updated
10/26/2016
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