Provider Demographics
NPI:1124613500
Name:ARARAT PHARMACY GROUP, INC.
Entity type:Organization
Organization Name:ARARAT PHARMACY GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GURGEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGDASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:818-637-2177
Mailing Address - Street 1:1248 S GLENDALE AVE STE M
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205
Mailing Address - Country:US
Mailing Address - Phone:818-637-2177
Mailing Address - Fax:818-637-2831
Practice Address - Street 1:1248 S GLENDALE AVE STE M
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205
Practice Address - Country:US
Practice Address - Phone:818-637-2177
Practice Address - Fax:818-637-2831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-07
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1700883949Medicaid