Organization
IDEAL PHARM
Active
Other names
HAUGEN'S IDEAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY GULVARTIAN (CEO)
(818) 246-1739
Entity
Organization
Contact information
Practice address
1155 N CENTRAL AVE, GLENDALE, CA 91202-2562
(818) 246-1739
(818) 246-1495
Mailing address
1155 N CENTRAL AVE, GLENDALE, CA 91202-2562
(818) 246-1739
(818) 246-1495
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
54483
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047820
PK
—
05
—
PHA310410
—
CA
Enumeration date
02/28/2007
Last updated
09/27/2016
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