Organization
OLIVE AVENUE MEDICAL PHARMACY INC
Active
Other names
OLIVE AVENUE MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE GRAFOS (OWNER AND PIC)
(818) 846-3144
Entity
Organization
Contact information
Practice address
1130 W OLIVE AVE, BURBANK, CA 91506-2214
(818) 846-3144
(818) 846-3838
Mailing address
1130 W OLIVE AVE, BURBANK, CA 91506-2214
(818) 846-3144
(818) 846-3838
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0529668
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA469070
—
CA
Enumeration date
08/06/2006
Last updated
07/13/2010
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