Organization
SUPREME CARE PHARMACY, INC.
Active
Other names
SUPREME CARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEVORG GRIGORYAN (PRESIDENT/OWNER)
(818) 763-7007
Entity
Organization
Contact information
Practice address
6007 LANKERSHIM BLVD, #7, NORTH HOLLYWOOD, CA 91606-4883
(818) 763-7007
(818) 763-7006
Mailing address
6007 LANKERSHIM BLVD, #7, NORTH HOLLYWOOD, CA 91606-4883
(818) 763-7007
(818) 763-7006
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417322736
—
CA
01
—
56-58096
NCPDP PROVIDER
CA
01
—
PHY53878
CALLFORNIA STATE BOARD OF PHARMACY
CA
Enumeration date
12/11/2015
Last updated
11/04/2025
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