Provider Demographics
NPI:1881308070
Name:HEALTH GUARD RX INC
Entity type:Organization
Organization Name:HEALTH GUARD RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/CFO/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROMELIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRVANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-222-8882
Mailing Address - Street 1:2355 HONOLULU AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-2500
Mailing Address - Country:US
Mailing Address - Phone:323-222-8882
Mailing Address - Fax:323-222-6686
Practice Address - Street 1:2355 HONOLULU AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-2500
Practice Address - Country:US
Practice Address - Phone:323-222-8882
Practice Address - Fax:323-222-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY57967OtherBOARD OF PHARMACY