Healthcare Provider Details

I. General information

NPI: 1487891438
Provider Name (Legal Business Name): BJRX PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 E MARCH LN SUITE:B280
STOCKTON CA
95210-6629
US

IV. Provider business mailing address

1801 E MARCH LN SUITE:B280
STOCKTON CA
95210-6629
US

V. Phone/Fax

Practice location:
  • Phone: 209-474-2888
  • Fax: 209-474-3328
Mailing address:
  • Phone: 209-474-2888
  • Fax: 209-474-3328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY 49785
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY 49785
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY 49785
License Number StateCA

VIII. Authorized Official

Name: PRATAP K ANNE
Title or Position: PHARMACIST INCHARGE
Credential: RPH
Phone: 209-474-2888