Organization
BURBANK COMPOUNDING PHARMACY INC
Active
Organization
BURBANK COMPOUNDING PHARMACY INC
Active
Other names
BURBANK COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ARMEN TATEVOSSIAN PHARM.D (PRESIDENT)
(818) 563-2120
Entity
Organization
Contact information
Practice address
201 S BUENA VISTA ST, STE 110, BURBANK, CA 91505-4569
(818) 563-2120
(818) 563-2130
Mailing address
201 S BUENA VISTA ST, STE 110, BURBANK, CA 91505-4569
(818) 563-2120
(818) 563-2130
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY48873
CA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2112936
PK
—
Enumeration date
07/22/2006
Last updated
10/07/2016
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