Provider Demographics
NPI:1902248453
Name:UNICHOICE, INC
Entity Type:Organization
Organization Name:UNICHOICE, INC
Other - Org Name:GLENMED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARBI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYRAPETIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-631-1708
Mailing Address - Street 1:1436 W GLENOAKS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1984
Mailing Address - Country:US
Mailing Address - Phone:818-409-9020
Mailing Address - Fax:818-409-9043
Practice Address - Street 1:1436 W GLENOAKS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1984
Practice Address - Country:US
Practice Address - Phone:818-409-9020
Practice Address - Fax:818-409-9043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51534333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902248453Medicaid