Provider Demographics
NPI:1083409585
Name:BURBANK COMPOUNDING PHARMACY INC
Entity type:Organization
Organization Name:BURBANK COMPOUNDING PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:TRINH
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:818-563-2120
Mailing Address - Street 1:201 S BUENA VISTA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4570
Mailing Address - Country:US
Mailing Address - Phone:818-563-2120
Mailing Address - Fax:818-563-2130
Practice Address - Street 1:201 S BUENA VISTA ST STE 110
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4570
Practice Address - Country:US
Practice Address - Phone:818-563-2120
Practice Address - Fax:818-563-2130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy