Healthcare Provider Details

I. General information

NPI: 1962950741
Provider Name (Legal Business Name): BK PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 08/22/2023
Certification Date: 08/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6741 N WILLOW AVE 106
FRESNO CA
93710-5955
US

IV. Provider business mailing address

6741 N WILLOW AVE STE 106
FRESNO CA
93710-5955
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-8888
  • Fax: 559-325-2888
Mailing address:
  • Phone: 559-325-6581
  • Fax: 559-325-6627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number54539
License Number StateCA

VIII. Authorized Official

Name: SHELDON KONG
Title or Position: PRESIDENT/ PHARMACIST
Credential: PHARM D
Phone: 559-297-8888