Provider Demographics
NPI:1871046482
Name:ALL CITY PHARMACY LLC
Entity Type:Organization
Organization Name:ALL CITY PHARMACY LLC
Other - Org Name:ALL CITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARAKHANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-465-7770
Mailing Address - Street 1:821 N LAMB BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5439
Mailing Address - Country:US
Mailing Address - Phone:725-465-7770
Mailing Address - Fax:725-465-7771
Practice Address - Street 1:821 N LAMB BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5439
Practice Address - Country:US
Practice Address - Phone:725-465-7770
Practice Address - Fax:725-465-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-31
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NVPH036093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164435OtherPK