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General NPI Number Information
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NPI Number | 1871693804
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Entity Type | Organization
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Legal Business Name | CENTRAL DRUGS & MEDICAL SUPPLY, LLC.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1510 SOUTH CENTRAL AVENUE STE 110
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City | GLENDALE
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State | CA
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Zip | 91204
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Country | US
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Telephone | 818-247-0526
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Fax | 818-247-3076
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Provider Business Mailing Address
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Address Line | 1510 SOUTH CENTRAL AVENUE STE 110
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City | GLENDALE
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State | CA
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Zip | 91204
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Country | US
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Telephone | 818-247-0526
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Fax | 818-247-3076
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | ZOHRAB KHACHERYAN
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Credential | PHARM.D.
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Telephone | 323-333-4074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY35919
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License Number State | CA
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