Provider Demographics
NPI:1104652353
Name:HARVARD FAMILY PHARMACY INC
Entity type:Organization
Organization Name:HARVARD FAMILY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MKHITARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-662-0700
Mailing Address - Street 1:145 S GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1108
Mailing Address - Country:US
Mailing Address - Phone:818-662-0700
Mailing Address - Fax:818-662-0701
Practice Address - Street 1:145 S GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1108
Practice Address - Country:US
Practice Address - Phone:818-662-0700
Practice Address - Fax:818-662-0701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARVARD FAMILY PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy