Central Drugs & Medical Supply, LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY35919 Issued in CA

Legal business name

CENTRAL DRUGS & MEDICAL SUPPLY, LLC.

Practice address

1510 South Central Avenue Ste 110
Glendale, CA 91204

Phone

(818) 247-0526

Fax

(818) 247-3076

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Zohrab Khacheryan, PHARM.D.NPI 1124682802

Title

Owner/Pharmacist in Charge

Phone

(323) 333-4074

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEMORIAL MEDICAL PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Zohrab Khacheryan

  • Pharmacist
  • Montrose, CA
  • NPI 1124682802
  NPD Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1871693804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 SOUTH CENTRAL AVENUE STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91204",
            "telephone_number": "818-247-0526",
            "fax_number": "818-247-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 SOUTH CENTRAL AVENUE STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91204",
            "telephone_number": "818-247-0526",
            "fax_number": "818-247-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DRUGS & MEDICAL SUPPLY, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "KHACHERYAN",
        "authorized_official_first_name": "ZOHRAB",
        "authorized_official_title_or_position": "OWNER/PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "323-333-4074",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY35919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "0500656",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIAL MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEMORIAL MEDICAL 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 Feb 18, 2020; 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.