Healthcare Provider Details

I. General information

NPI: 1275930638
Provider Name (Legal Business Name): TRIPLE S R PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N BRAND BLVD STE 306
GLENDALE CA
91203-4251
US

IV. Provider business mailing address

1146 N CENTRAL AVE # 697
GLENDALE CA
91202-2506
US

V. Phone/Fax

Practice location:
  • Phone: 800-557-5555
  • Fax: 800-557-9095
Mailing address:
  • Phone: 800-557-5555
  • Fax: 800-557-9095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY55417
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY55417
License Number StateCA

VIII. Authorized Official

Name: DR. SARKIS JARAKIAN
Title or Position: PRESIDENT/PIC
Credential: PHARM D
Phone: 800-557-5555