Provider Demographics
NPI:1134270135
Name:FOOTHILL REMEDY DRUGS
Entity type:Organization
Organization Name:FOOTHILL REMEDY DRUGS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVETIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-236-2500
Mailing Address - Street 1:6253 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2723
Mailing Address - Country:US
Mailing Address - Phone:818-236-2500
Mailing Address - Fax:818-236-2504
Practice Address - Street 1:6253 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2723
Practice Address - Country:US
Practice Address - Phone:818-236-2500
Practice Address - Fax:818-236-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336S0011X
CAPHY497823336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1993021OtherPK
CAPHA439740Medicaid
CA05-10241OtherNCPDP NUMBER
CAPHY 49782OtherSTATE BOARD OF PHARMACY PERMIT