Provider Demographics
NPI:1073289070
Name:PHARMACY OF THE WEST LLC
Entity Type:Organization
Organization Name:PHARMACY OF THE WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARTASHES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROUTUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-381-2368
Mailing Address - Street 1:1465 TAMARIND AVE # 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-8412
Mailing Address - Country:US
Mailing Address - Phone:323-713-0000
Mailing Address - Fax:
Practice Address - Street 1:1465 TAMARIND AVE # 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-8412
Practice Address - Country:US
Practice Address - Phone:323-713-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy