Provider Demographics
NPI:1871636571
Name:UNICARE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:UNICARE HEALTH SERVICES, INC.
Other - Org Name:UNICARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GEVORKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:626-793-7771
Mailing Address - Street 1:301 S FAIR OAKS AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2561
Mailing Address - Country:US
Mailing Address - Phone:626-793-7771
Mailing Address - Fax:626-793-7772
Practice Address - Street 1:301 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2561
Practice Address - Country:US
Practice Address - Phone:626-793-7771
Practice Address - Fax:626-793-7772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY47227333600000X
CAPHY484483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA151492OtherHOME FURNISHING AND THERM
CA1871636571Medicaid
CA5616151OtherNPI
CA1871636571Medicaid
CA151492OtherHOME FURNISHING AND THERM