Healthcare Provider Details

I. General information

NPI: 1942300983
Provider Name (Legal Business Name): GAA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 S GLENDALE AVE
GLENDALE CA
91205-3203
US

IV. Provider business mailing address

1112 S GLENDALE AVE
GLENDALE CA
91205-3203
US

V. Phone/Fax

Practice location:
  • Phone: 818-500-0800
  • Fax: 818-500-8527
Mailing address:
  • Phone: 818-500-0800
  • Fax: 818-500-8527

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ANET GABRIELYAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 818-414-2622