Organization Active NPI

Pacific Medical Pharmacy Inc

Doing business as Pacific Medical Pharmacy

  • Community/Retail Pharmacy
  • Glendale, CA
National Provider Identifier
1861596819
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
47398 Issued in CA
Legal business name
PACIFIC MEDICAL PHARMACY INC
Doing business as
Pacific Medical Pharmacy
Practice address
1101 N Pacific Ave
Ste 101
Glendale, CA 91202-3250
Phone
(818) 548-1330
Fax
(818) 548-3590
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Razmik Arakelian, PHARMD
Title
Owner
Phone
(818) 548-1330

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 47398 CA Primary

Addresses

Primary practice location

1101 N Pacific Ave
Ste 101
Glendale, CA 91202-3250

Mailing address

1101 N Pacific Ave
Ste 101
Glendale, CA 91202-3250
Phone (818) 548-1330

Other identifiers 2

IdentifierTypeStateIssuer
PHA405130MedicaidCA
1993080OtherPK

Other names 1

  • PACIFIC MEDICAL PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930065521 CA DME Supplier - Pharmacy 1254451792 Practice locations: Glendale, CA
O20180202001620 CA Part B Supplier - Mass Immunization (Roster Biller Only) 1254451792 1 other NPI on this enrollment
Practice locations: Glendale, CA
O20200531000044 CA Part B Supplier - Independent Clinical Laboratory 1254451792 Practice locations: Glendale, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
05D2151759Pacific Medical Pharmacy1101 N Pacific Ave Ste 101, Glendale, CA 91202Certificate of waiverJul 25, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pacific Medical1101 N Pacific Ave, Glendale, CA 91202-431081854813307 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2000

National Provider Directory

National Provider Directory

Locations

1101 N Pacific Ave
Ste 101
Glendale, CA 91202
Phone (818) 548-1330

808 E California Ave
Glendale, CA 91206
Phone (818) 696-2034

Practitioners & affiliated clinicians

Practitioners 7

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1861596819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE",
            "address_2": "STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023250",
            "telephone_number": "818-548-1330",
            "fax_number": "818-548-3590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PACIFIC AVE",
            "address_2": "STE 101",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023250",
            "telephone_number": "818-548-1330",
            "fax_number": "818-548-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC MEDICAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "ARAKELIAN",
        "authorized_official_first_name": "RAZMIK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-548-1330",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "47398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA405130",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1993080",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 29, 2017; 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.