Healthcare Provider Details

I. General information

NPI: 1083703979
Provider Name (Legal Business Name): ASAP RX CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/31/2021
Certification Date: 12/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 E WILSON AVE
GLENDALE CA
91206-4632
US

IV. Provider business mailing address

1340 E WILSON AVE
GLENDALE CA
91206-4632
US

V. Phone/Fax

Practice location:
  • Phone: 818-543-1800
  • Fax: 818-553-1900
Mailing address:
  • Phone: 818-543-1800
  • Fax: 818-553-1900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY 55466
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY 55466
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY 55466
License Number StateCA

VIII. Authorized Official

Name: DR. VAHE GAREN SIMONIAN
Title or Position: PHARMACIST
Credential: PHARM. D.
Phone: 818-543-1800