Provider Demographics
NPI:1851785042
Name:WESTCO DRUGS INC
Entity Type:Organization
Organization Name:WESTCO DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDVARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUTYUNYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-696-2099
Mailing Address - Street 1:1217 N CENTRAL AVE STE AA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3160
Mailing Address - Country:US
Mailing Address - Phone:818-696-2099
Mailing Address - Fax:818-937-1773
Practice Address - Street 1:1217 N CENTRAL AVE STE AA
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3160
Practice Address - Country:US
Practice Address - Phone:818-696-2099
Practice Address - Fax:818-937-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524253336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851785042Medicaid