Provider Demographics
NPI:1043041676
Name:SIRMID, INC
Entity type:Organization
Organization Name:SIRMID, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIRANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDURYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-509-3630
Mailing Address - Street 1:12660 RIVERSIDE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3430
Mailing Address - Country:US
Mailing Address - Phone:818-509-3630
Mailing Address - Fax:818-395-3626
Practice Address - Street 1:12660 RIVERSIDE DR STE 100
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3430
Practice Address - Country:US
Practice Address - Phone:818-509-3630
Practice Address - Fax:818-395-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy