Healthcare Provider Details
I. General information
NPI: 1013674944
Provider Name (Legal Business Name): AGH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2021
Last Update Date: 11/28/2021
Certification Date: 11/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4590 E CLINTON AVE
FRESNO CA
93703-2659
US
IV. Provider business mailing address
7212 N STACIA AVE
FRESNO CA
93720-0311
US
V. Phone/Fax
- Phone: 559-916-0346
- Fax:
- Phone: 559-273-1706
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAROUTUN
HARRY
POGOSYAN
Title or Position: SECRETARY
Credential: PHA TEC
Phone: 559-273-1706