Organization
BURBANK VILLAGE COMPOUNDING PHARMACY INC
Active
Organization
BURBANK VILLAGE COMPOUNDING PHARMACY INC
Active
Other names
BURBANK VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RAFI KHOBIARIAN PHARMD (PIC, PRESIDENT)
(818) 260-0062
Entity
Organization
Contact information
Practice address
337 E MAGNOLIA BLVD, BURBANK, CA 91502
(818) 260-0062
(818) 260-0089
Mailing address
337 E MAGNOLIA BLVD, BURBANK, CA 91502
(818) 260-0062
(818) 260-0089
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY50950
CA
3336C0003X
Community/Retail Pharmacy
Primary
PHY50950
CA
3336C0004X
Compounding Pharmacy
PHY50950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225397086
—
CA
01
—
PHY50950
CALIFORNIA STATE BOARD OF PHARMACY RETAIL PERMIT
CA
Enumeration date
05/14/2012
Last updated
01/17/2024
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