Provider Demographics
NPI:1407915606
Name:ARACOLA, INC
Entity Type:Organization
Organization Name:ARACOLA, INC
Other - Org Name:RILEY'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:818-244-1195
Mailing Address - Street 1:411 N CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2081
Mailing Address - Country:US
Mailing Address - Phone:818-244-1195
Mailing Address - Fax:818-242-2836
Practice Address - Street 1:411 N CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2081
Practice Address - Country:US
Practice Address - Phone:818-244-1195
Practice Address - Fax:818-242-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 550653336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1407915606Medicaid
CABR61093236OtherDEA
CAPHA436190Medicaid
CABR61093236OtherDEA