Provider Demographics
NPI:1942292917
Name:RAFFI G HARTOUNIAN PHARMACIST APC HEART DRUGS
Entity Type:Organization
Organization Name:RAFFI G HARTOUNIAN PHARMACIST APC HEART DRUGS
Other - Org Name:HEART DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFFI
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARTOUNIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:562-692-4278
Mailing Address - Street 1:11120 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-1432
Mailing Address - Country:US
Mailing Address - Phone:562-692-4278
Mailing Address - Fax:562-692-7149
Practice Address - Street 1:11120 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-1432
Practice Address - Country:US
Practice Address - Phone:562-692-4278
Practice Address - Fax:562-692-7149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-16
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY46270333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0549470OtherNCPDP
CAPHA462700Medicaid
CA0549470OtherNCPDP