Healthcare Provider Details

I. General information

NPI: 1427819556
Provider Name (Legal Business Name): UPTOWN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 W WHITTIER BLVD
MONTEBELLO CA
90640-3041
US

IV. Provider business mailing address

2418 W WHITTIER BLVD
MONTEBELLO CA
90640-3041
US

V. Phone/Fax

Practice location:
  • Phone: 310-907-5957
  • Fax: 310-946-0840
Mailing address:
  • Phone: 310-907-5957
  • Fax: 310-946-0840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAZAR HAVANJYAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 310-907-5957