Provider Demographics
NPI:1699572248
Name:WELLMED PHARMACY
Entity type:Organization
Organization Name:WELLMED PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAGOP
Authorized Official - Middle Name:
Authorized Official - Last Name:DARAKCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-433-7166
Mailing Address - Street 1:2701 W ALAMEDA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 W ALAMEDA AVE STE 100
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4402
Practice Address - Country:US
Practice Address - Phone:818-433-7166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy