Organization
LILAC PHARMACY INC
Active
Other names
LILAC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HAYKUHI HAVANJYAN PHARM D (PRESIDENT/CEO)
(818) 337-1123
Entity
Organization
Contact information
Practice address
2519 W BURBANK BLVD, BURBANK, CA 91505-2302
(818) 337-1123
(818) 337-1124
Mailing address
2519 W BURBANK BLVD, BURBANK, CA 91505-2302
(818) 337-1123
(818) 337-1124
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY60680
BOARD OF PHARMACY
CA
Enumeration date
06/09/2023
Last updated
05/29/2025
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