Healthcare Provider Details

I. General information

NPI: 1912609223
Provider Name (Legal Business Name): CENTRAL PHARMACY GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S CHEVY CHASE DR STE 111
GLENDALE CA
91205-4435
US

IV. Provider business mailing address

801 S CHEVY CHASE DR STE 111
GLENDALE CA
91205-4435
US

V. Phone/Fax

Practice location:
  • Phone: 818-502-9097
  • Fax: 818-502-9750
Mailing address:
  • Phone: 818-502-9097
  • Fax: 818-502-9750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAFFI PAPAZIAN
Title or Position: PIC
Credential: PHARMD
Phone: 818-502-9097