Healthcare Provider Details

I. General information

NPI: 1518892892
Provider Name (Legal Business Name): SKY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2210 HONOLULU AVE
MONTROSE CA
91020-1617
US

IV. Provider business mailing address

2210 HONOLULU AVE
MONTROSE CA
91020-1617
US

V. Phone/Fax

Practice location:
  • Phone: 747-255-7040
  • Fax: 747-255-7292
Mailing address:
  • Phone: 747-255-7040
  • Fax: 747-255-7292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VARDUHI GRIGORYAN
Title or Position: CEO/PIC
Credential: PHARMD
Phone: 747-255-7040