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General NPI Number Information
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NPI Number | 1457775736
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Entity Type | Organization
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Legal Business Name | UNICARE PHARMACY & SUPPLY INC
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 301 S FAIR OAKS AVE STE 104
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City | PASADENA
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State | CA
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Zip | 91105-2561
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Country | US
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Telephone | 626-793-7771
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Fax | 626-793-7772
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Provider Business Mailing Address
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Address Line | 301 S FAIR OAKS AVE STE 104
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City | PASADENA
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State | CA
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Zip | 91105-2561
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Country | US
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Telephone | 626-793-7771
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Fax | 626-793-7772
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Authorized Official
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Title or Position | CEO
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Name | LILI GEVORKIAN
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Credential | RPH
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Telephone | 626-793-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY51250
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License Number State | CA
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