=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902606619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLENDRX INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2025
-----------------------------------------------------
Last Update Date | 03/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4128 W BURBANK BLVD
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91505-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-697-0058
-----------------------------------------------------
Fax | 818-697-6785
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4128 W BURBANK BLVD
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91505-2121
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-697-0058
-----------------------------------------------------
Fax | 818-697-6785
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SECRETARY/PIC
-----------------------------------------------------
Name | DR. AREN SAHAKIAN
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 818-697-0058
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0004X
-----------------------------------------------------
Taxonomy Name | Compounding Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------