Active NPI
Lilac Pharmacy Inc
- Community/Retail Pharmacy
- Burbank, CA
National Provider Identifier
1700560885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- LILAC PHARMACY INC
- Practice address
- 2519 W Burbank Blvd
Burbank, CA 91505-2302 - Phone
- (818) 337-1123
- Fax
- (818) 337-1124
- NPI assigned
- Jun 9, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Haykuhi Havanjyan, PHARM D
- Title
- President/Ceo
- Phone
- (818) 337-1123
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
2519 W Burbank Blvd
Burbank, CA 91505-2302
Mailing address
2519 W Burbank Blvd
Burbank, CA 91505-2302
Phone (818) 337-1123
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHY60680 | Other | CA | BOARD OF PHARMACY |
Other names 1
- LILAC PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231201001122 | CA | DME Supplier - Pharmacy | 8426406422 | Practice locations: Simi Valley, CA |
National Provider Directory
National Provider DirectoryLocations
2519 W Burbank Blvd
Burbank, CA 91505
Phone (818) 736-5290
2139 Tapo St
Ste 213
Simi Valley, CA 93063
Phone (805) 526-0269
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Lancaster, CA
- NPI 1316487564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686268800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748476800000",
"number": "1700560885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2519 W BURBANK BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052302",
"telephone_number": "818-337-1123",
"fax_number": "818-337-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2519 W BURBANK BLVD",
"city": "BURBANK",
"state": "CA",
"postal_code": "915052302",
"telephone_number": "818-337-1123",
"fax_number": "818-337-1124"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LILAC PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-09",
"last_updated": "2025-05-29",
"certification_date": "2025-05-29",
"status": "A",
"authorized_official_last_name": "HAVANJYAN",
"authorized_official_first_name": "HAYKUHI",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "818-337-1123",
"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": "PHY60680",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LILAC PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "LILAC 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 May 29, 2025; 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.