Provider Demographics
NPI:1598816571
Name:THREE WISE MEN, INC.
Entity Type:Organization
Organization Name:THREE WISE MEN, INC.
Other - Org Name:REMEDY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DIR.
Authorized Official - Prefix:
Authorized Official - First Name:ANDRANIK
Authorized Official - Middle Name:
Authorized Official - Last Name:HARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-489-3653
Mailing Address - Street 1:1700 W. GLENOAKS BLVD.
Mailing Address - Street 2:UNIT E
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201
Mailing Address - Country:US
Mailing Address - Phone:818-549-1010
Mailing Address - Fax:818-549-0505
Practice Address - Street 1:1700 W. GLENOAKS BLVD.
Practice Address - Street 2:UNIT E
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201
Practice Address - Country:US
Practice Address - Phone:818-549-1010
Practice Address - Fax:818-549-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY421293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA421290Medicaid
2002533OtherPK