Organization
BEVERLY GLEN PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM MICHAEL BURMAN (PRESIDENT)
(310) 475-0568
Entity
Organization
Contact information
Practice address
2946 N BEVERLY GLEN CIR, LOS ANGELES, CA 90077-1724
(310) 475-0568
(310) 475-5478
Mailing address
2946 N BEVERLY GLEN CIR, LOS ANGELES, CA 90077-1724
(310) 475-0568
(310) 475-5478
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY55866
CA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1998727
PK
—
Enumeration date
09/21/2006
Last updated
01/19/2021
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