Provider Demographics
NPI:1679046775
Name:GROVE RX INC
Entity type:Organization
Organization Name:GROVE RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POGOSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-390-4011
Mailing Address - Street 1:655 N FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3383
Mailing Address - Country:US
Mailing Address - Phone:626-390-4011
Mailing Address - Fax:626-640-3072
Practice Address - Street 1:655 N FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3383
Practice Address - Country:US
Practice Address - Phone:626-390-4011
Practice Address - Fax:626-640-3072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59158OtherBOARD OF PHARMACY