Organization Active NPI

Petrossian Pharmacy Inc

Doing business as Petrossian Pharmacy

  • Community/Retail Pharmacy
  • Burbank, CA
National Provider Identifier
1356050595
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
PETROSSIAN PHARMACY INC
Doing business as
Petrossian Pharmacy
Practice address
2701 W Alameda Ave Ste 100
Burbank, CA 91505-4402
Phone
(818) 433-7166
Fax
(818) 433-7163
NPI assigned
Nov 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Narbeh Petrossian, PHARM DNPI 1629456165
Title
President/Ceo
Phone
(818) 433-7166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

2701 W Alameda Ave Ste 100
Burbank, CA 91505-4402

Mailing address

2701 W Alameda Ave Ste 100
Burbank, CA 91505-4402
Phone (818) 433-7166

Other identifiers 1

IdentifierTypeStateIssuer
PHY58822OtherCABOARD OF PHARMACY

Other names 1

  • PETROSSIAN PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231106000255 CA Part B Supplier - Mass Immunization (Roster Biller Only) 0749643914 Practice locations: Burbank, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1356050595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054402",
            "telephone_number": "818-433-7166",
            "fax_number": "818-433-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W ALAMEDA AVE STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054402",
            "telephone_number": "818-433-7166",
            "fax_number": "818-433-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETROSSIAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "PETROSSIAN",
        "authorized_official_first_name": "NARBEH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-433-7166",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "PHY58822",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETROSSIAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.