NPIMap

Organization Active NPI

Medirect, Inc.

  • Preferred Provider Organization
  • Glendale, CA
National Provider Identifier
1497028534
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
MEDIRECT, INC.
Practice address
412 W Broadway Ste 210
Glendale, CA 91204-1297
Phone
(818) 545-1113
Fax
(888) 420-3178
NPI assigned
Feb 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Akop Jack Demirchyan
Title
C.E.O
Phone
(818) 545-1113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X CA Primary

Addresses

Primary practice location

412 W Broadway Ste 210
Glendale, CA 91204-1297

Mailing address

PO Box 251479
Glendale, CA 91225-1479
Phone (818) 545-1113

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497028534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251479",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912251479",
            "telephone_number": "818-545-1113",
            "fax_number": "888-420-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W BROADWAY STE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041297",
            "telephone_number": "818-545-1113",
            "fax_number": "888-420-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIRECT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DEMIRCHYAN",
        "authorized_official_first_name": "AKOP",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "C.E.O",
        "authorized_official_telephone_number": "818-545-1113"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.