Provider Demographics
NPI:1295543155
Name:GLENDALE ADVENTIST MEDICAL CENTER
Entity type:Organization
Organization Name:GLENDALE ADVENTIST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ROMIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ESKANDARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-720-4161
Mailing Address - Street 1:1505 WILSON TERRACE #100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206
Mailing Address - Country:US
Mailing Address - Phone:818-409-8319
Mailing Address - Fax:818-863-4906
Practice Address - Street 1:1505 WILSON TERRACE #100
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206
Practice Address - Country:US
Practice Address - Phone:818-409-8319
Practice Address - Fax:818-863-4906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy