Organization
GLENDALE WEST DRUG CO INC
Active
Other names
glendale west pharmacy and medical supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MALEK SET ALLAHDADAI (PRESIDENT)
(818) 548-5157
Entity
Organization
Contact information
Practice address
1109 S GLENDALE AVE, GLENDALE, CA 91205-5657
(818) 548-5157
(818) 548-1064
Mailing address
1109 S GLENDALE AVE, GLENDALE, CA 91205-5657
(818) 548-5157
(818) 548-1064
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY43706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA437060
—
CA
Enumeration date
10/11/2005
Last updated
08/22/2020
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