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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