Organization
IVANHOE DRUG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY C OHANESIAN RPH. (PIC / PHARMACIST)
(559) 798-0861
Entity
Organization
Contact information
Practice address
33060 ROAD 159, IVANHOE, CA 93235-1235
(559) 798-0861
(559) 798-1815
Mailing address
33060 ROAD 159, IVANHOE, CA 93235-1235
(559) 798-0861
(559) 798-1815
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY 32581
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHY 32581
CA
333600000X
Pharmacy
Primary
PHY 32581
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA 325810
—
CA
Enumeration date
08/23/2005
Last updated
09/11/2025
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