Organization Active NPI

Grand Polite Inc.

  • Community/Retail Pharmacy
  • Tujunga, CA
National Provider Identifier
1184387615
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GRAND POLITE INC.
Practice address
6624 Foothill Blvd
Tujunga, CA 91042
Phone
(818) 875-4053
Fax
(818) 875-4063
NPI assigned
Oct 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Arthur Karo Hagopian, PHARM D.NPI 1417469081
Title
Pharmacist
Phone
(818) 624-5010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

6624 Foothill Blvd
Tujunga, CA 91042

Mailing address

6624 Foothill Blvd
Tujunga, CA 91042
Phone (818) 875-4053

Other names 2

  • pacific medical phamrcy Doing business as
  • pacific medical pharmacy 3 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220224000438 CA DME Supplier - Pharmacy 3072907641 Practice locations: Tujunga, CA
O20220829002481 CA Part B Supplier - Mass Immunization (Roster Biller Only) 3072907641 Practice locations: Tujunga, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2276195Pacific Medical Pharmacy #36624 Foothill Blvd, Tujunga, CA 91042Certificate of waiverFeb 2, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pacific Medical Pharmacy 36624 Foothill Blvd, Tujunga, CA 91042-2797(818) 875-4053 Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Aug 25, 2022

National Provider Directory

National Provider Directory

Locations

6624 Foothill Blvd
Tujunga, CA 91042
Phone (818) 875-4053

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1184387615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6624 FOOTHILL BLVD",
            "city": "TUJUNGA",
            "state": "CA",
            "postal_code": "91042",
            "telephone_number": "818-875-4053",
            "fax_number": "818-875-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6624 FOOTHILL BLVD",
            "city": "TUJUNGA",
            "state": "CA",
            "postal_code": "91042",
            "telephone_number": "818-875-4053",
            "fax_number": "818-875-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND POLITE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "HAGOPIAN",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "KARO",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "818-624-5010",
        "authorized_official_credential": "PHARM D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pacific medical phamrcy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "pacific medical pharmacy 3",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "pacific medical pharmacy 3",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tujunga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.