Ideal Pharm

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54483 Issued in CA

Legal business name

IDEAL PHARM

Doing business as

Haugen's Ideal Pharmacy

Practice address

1155 N Central Ave
Glendale, CA 91202-2562

Phone

(818) 246-1739

Fax

(818) 246-1495

NPI assigned

Feb 28, 2007

Last updated

Sep 27, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lucy Gulvartian

Title

Ceo

Phone

(818) 246-1739

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• HAUGEN'S IDEAL PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1023145869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022562",
            "telephone_number": "818-246-1739",
            "fax_number": "818-246-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022562",
            "telephone_number": "818-246-1739",
            "fax_number": "818-246-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL PHARM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "GULVARTIAN",
        "authorized_official_first_name": "LUCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-246-1739"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA310410",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047820",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAUGEN'S IDEAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Glendale, CA
• Providers in Glendale, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.