Organization
GLENDALE PHARMACY INC
Active
Other names
Colalta Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RITA AVAKIAN (PRESIDENT)
(818) 521-4101
Entity
Organization
Contact information
Practice address
2498 E COLORADO BLVD, PASADENA, CA 91107-4250
(818) 244-3164
(818) 244-1145
Mailing address
2498 E COLORADO BLVD, PASADENA, CA 91107-4250
(818) 244-3164
(818) 244-1145
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1990406
PK
—
05
—
PHA484210
—
CA
Enumeration date
08/10/2006
Last updated
04/16/2025
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