Provider Demographics
NPI:1629013834
Name:GARYS ALL-MED DRUGS INC
Entity Type:Organization
Organization Name:GARYS ALL-MED DRUGS INC
Other - Org Name:IVANHOE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OHANESIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH DBA
Authorized Official - Phone:559-798-0861
Mailing Address - Street 1:7944 N MAPLE AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0289
Mailing Address - Country:US
Mailing Address - Phone:559-323-3998
Mailing Address - Fax:559-323-3981
Practice Address - Street 1:7944 N MAPLE AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0289
Practice Address - Country:US
Practice Address - Phone:559-323-3998
Practice Address - Fax:559-323-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY473703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA325180Medicaid
CAPHA325180Medicaid
CAPHA325180Medicaid