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OLYMPIA PLAZA PHARMACY
NPI 1477615003
Pharmacy - Community/Retail Pharmacy in Los Angeles, CA

Active since December 13, 2006CLIA 05D2215728 · Waiver
5901 W OLYMPIC BLVD, SUITE 103, LOS ANGELES, CA 90036(323) 937-2590(323) 937-0259 Get Directions Write a Review

NPPES record last updated: September 4, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Olympia Plaza Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLYMPIA PLAZA PHARMACY (NPI 1477615003) is a healthcare organization registered as a community/retail pharmacy in Los Angeles, California and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through March 4, 2027 and lists Tatyana Borokhovich, Pic, as its authorized official.

NPPES Registry Identity

NPI1477615003
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameOLYMPIA PLAZA PHARMACY INC
Location Address5901 W OLYMPIC BLVD, SUITE 103Los Angeles, CA 90036-4667
Mailing Address5901 W Olympic Blvd, Suite 103Los Angeles, CA 90036-4667 · (323) 937-2590 · Fax (323) 937-0259
Phone(323) 937-2590
Fax(323) 937-0259
Organization SubpartNo
Authorized OfficialTatyana BorokhovichPic · (323) 937-2590
Enumeration DateDecember 13, 2006
Last NPPES UpdateSeptember 4, 2012
✔ NPI 1477615003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in CA · PHY48416
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
Also ListedPharmacy · Specialty PharmacyTaxonomy 3336S0011X · License PHY 48416 (CA)
5901 W OLYMPIC BLVD, Los Angeles, CA 90036
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Other Names 1

Doing Business AsOlympia Plaza Pharmacy

Other Identifiers 3

Medicare NSC5942080001
Other0597902Ncpdp Provider Identification Number
Medicaid1477615003CA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Olympia Plaza Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20100930008271DME · PharmacyDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2215728

Olympia Plaza Pharmacy · Los Angeles, CA
Active · expires Mar 4, 2027
CLIA Number05D2215728
Laboratory TypePharmacy
Certificate Effective DateMarch 5, 2025
Certificate Expiration DateMarch 4, 2027
Laboratory DirectorEmil Borokhovich
Laboratory Phone(323) 937-2590
Laboratory LocationOlympia Plaza Pharmacy5901 W Olympic Blvd Suite 103, Los Angeles, CA 90036
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
17 services17 patients

Medical Equipment Supplier Medicare DMEPOS 13

Medicare supplier enrollment and the product categories Olympia Plaza Pharmacy Inc carries, from the Medicare DMEPOS supplier directory.

Olympia Plaza Pharmacy Inc

DMEPOS supplier · Los Angeles, CA
⋮

Does not accept Medicare assignment

Olympia Plaza Pharmacy Inc has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20571767
Medicare Participant SinceNovember 6, 2006
Supplier Location5901W Olympic Blvd 103Los Angeles, CA 90036
Phone(323) 937-2590
Provider TypeOxygen & Equipment
Supplier Specialties
Pharmacy

Medicare Product Categories

Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Heat & Cold Applications
Heat therapy, Cold therapy, Heating pads
External Infusion Pumps and/or Supplies
An infusion pump is necessary to safely administer the drug
Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Orthoses: Off-The-Shelf
Met pads, Heel pads, Heel spur pads
Ostomy Supplies
Pouches, Paste, Powder, Barrier wipes
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALFRED RAHBAN M.D.A MEDICAL CORPOR
Internal Medicine (Nephrology)
5901 W OLYMPIC BLVD, SUITE 307
LOS ANGELES, CA 90036
Los Angeles County (323) 939-3669
GEORGE FOULADIAN, M.D. MEDICAL GROUP
Internal Medicine (Nephrology)
5901 W OLYMPIC BLVD, SUITE 307
LOS ANGELES, CA 90036
Los Angeles County (323) 931-2020
GLOBAL HEALTHCARE INC
Internal Medicine (Infectious Disease)
5901 W OLYMPIC BLVD, 500
LOS ANGELES, CA 90036
Los Angeles County (323) 215-1725
DR. ANNE LOUISE PETERS M.D.
Internal Medicine
5901 W OLYMPIC BLVD, #208
LOS ANGELES, CA 90036
Los Angeles County (323) 936-8283
SLEEPMED OF CALIFORNIA
Durable Medical Equipment & Medical Supplies
5901 W OLYMPIC BLVD, SUITE 102
LOS ANGELES, CA 90036
Los Angeles County (323) 933-0422
CONSERVATIVE CARE SPECIALISTS MEDICAL GROUP INC.
Non-Pharmacy Dispensing Site
5901 W OLYMPIC BLVD, SUITE 204
LOS ANGELES, CA 90036
Los Angeles County (818) 781-6684
ALI HARIRI M.D.
Internal Medicine (Nephrology)
5901 W OLYMPIC BLVD, 305
LOS ANGELES, CA 90036
Los Angeles County (323) 655-5068
GEORGE FOULADIAN MD INC A CALIFORNIA PROFESSIONAL CORP
Internal Medicine (Nephrology)
5901 W OLYMPIC BLVD, SUITE 307
LOS ANGELES, CA 90036
Los Angeles County (323) 931-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olympia Plaza Pharmacy Inc's NPI number?

The NPI number for Olympia Plaza Pharmacy Inc is 1477615003. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is doing business as Olympia Plaza Pharmacy.

Where is Olympia Plaza Pharmacy Inc located?

Olympia Plaza Pharmacy Inc is located at 5901 W Olympic Blvd Suite 103, Los Angeles, CA 90036. The listed phone number is (323) 937-2590.

What is Olympia Plaza Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Olympia Plaza Pharmacy Inc enrolled in Medicare?

Yes. Olympia Plaza Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Olympia Plaza Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (California, Pharmacy) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Olympia Plaza Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Olympia Plaza Pharmacy Inc does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

Does Olympia Plaza Pharmacy Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2215728) is associated with this NPI, valid through March 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Olympia Plaza Pharmacy Inc accept?

Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and Baylor Scott and White Health Plan and 15 other insurers list Olympia Plaza Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Olympia Plaza Pharmacy Inc was last updated on September 4, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.