=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033135983
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIOPLUS SPECIALTY INFUSION CA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 12/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19110 VAN NESS AVE
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-320-6444
-----------------------------------------------------
Fax | 866-794-4844
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19110 VAN NESS AVE
-----------------------------------------------------
City | TORRANCE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90501-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-320-6444
-----------------------------------------------------
Fax | 866-794-4844
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CREDENTIALING SPECIALIST
-----------------------------------------------------
Name | ASHLEY SHEEHAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 855-733-3126
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY54649
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336H0001X
-----------------------------------------------------
Taxonomy Name | Home Infusion Therapy Pharmacy
-----------------------------------------------------
License Number | PHY54649
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------