MEDICARE: GOLDEN CARE PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PHY 50379	CA

General Provider Information

NPI Number	:	1508171786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN CARE PHARMACY INC

Provider Business Mailing Address
First Line	:	4128 S BROADWAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2221
Country	:	US
Telephone Number	:	323-234-9956
Fax Number	:	323-234-0060

Provider Business Practice Location Address
First Line	:	4128 S BROADWAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2221
Country	:	US
Telephone Number	:	323-234-9956
Fax Number	:	323-234-0060

Authorized Official
Title or Position	:	PRESIDENT/PHARMACY TECHNICIAN
Name	:	MS. IRINA BOROZANYAN
Credential	:	PHARMACY TECHNICIAN
Telephone Number	:	323-234-9956

Provider Enumeration Date	:	08/12/2010
Last Update Date	:	02/19/2021

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Directions to “GOLDEN CARE PHARMACY INC ” Practice Location

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