Provider Demographics
NPI:1609057371
Name:H & H DRUG STORES, INC
Entity Type:Organization
Organization Name:H & H DRUG STORES, INC
Other - Org Name:WESTERN DRUG MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CONTRACTING
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DERTSAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-956-6691
Mailing Address - Street 1:3604 SAN FERNANDO RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2917
Mailing Address - Country:US
Mailing Address - Phone:818-956-2104
Mailing Address - Fax:818-956-6317
Practice Address - Street 1:3604 SAN FERNANDO RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2917
Practice Address - Country:US
Practice Address - Phone:818-956-2104
Practice Address - Fax:818-956-6317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1992793269
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336H0001X
CAPHY449573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY44957OtherPHARMACY LICENSE