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General NPI Number Information
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NPI Number | 1821091596
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Entity Type | Organization
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Legal Business Name | EXPRESS CARE PHARMACY INC.
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 801 E BROADWAY UNIT A
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City | GLENDALE
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State | CA
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Zip | 91205-4528
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Country | US
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Telephone | 818-244-3330
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Fax | 818-244-5530
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Provider Business Mailing Address
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Address Line | 801 E BROADWAY UNIT A
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City | GLENDALE
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State | CA
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Zip | 91205-4528
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Country | US
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Telephone | 818-244-3330
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Fax | 818-244-5530
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MIKAYEL MIKAYELYAN
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Credential |
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Telephone | 818-244-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY50437
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License Number State | CA
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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 | PHY50437
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License Number State | CA
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