Organization
GBV CORPORATION
Active
Other names
Arcade Lane Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GAYANE BESNELIAN (PRESIDENT/PIC)
(626) 577-7979
Entity
Organization
Contact information
Practice address
700 E COLORADO BLVD, PASADENA, CA 91101-2102
(626) 577-7979
(626) 577-7977
Mailing address
700 E COLORADO BLVD, PASADENA, CA 91101-2102
(626) 577-7979
(626) 577-7977
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
50930
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5644009
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/21/2012
Last updated
08/21/2012
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