Organization
AMERICAN HERITAGE PHARMACY INC
Active
Other names
GOLDEN RX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ADRINE KHUDANYAN (PRESIDENT/CEO)
(209) 697-2000
Entity
Organization
Contact information
Practice address
830 E STATE HIGHWAY, 88, JACKSON, CA 95642-2134
(209) 697-2000
(209) 697-2222
Mailing address
830 E STATE HIGHWAY, 88, JACKSON, CA 95642-2134
(209) 697-2000
(209) 697-2222
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY59097
BOARD OF PHARMACY
CA
Enumeration date
12/09/2024
Last updated
12/09/2024
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