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General NPI Number Information
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NPI Number | 1043202146
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Entity Type | Organization
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Legal Business Name | BEVERLY PLAZA RX INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 101 E BEVERLY BLVD STE 101
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City | MONTEBELLO
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State | CA
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Zip | 90640-4314
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Country | US
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Telephone | 323-725-7155
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Fax | 323-725-7766
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Provider Business Mailing Address
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Address Line | 101 E BEVERLY BLVD STE 101
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City | MONTEBELLO
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State | CA
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Zip | 90640-4314
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Country | US
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Telephone | 323-725-7155
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Fax | 323-725-7766
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Authorized Official
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Title or Position | PRESIDENT/CEO/CFO/SECRETARY/DIRECTO
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Name | MR. MAIS MELIKIAN
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Credential |
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Telephone | 323-725-7155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 53865
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License Number State | CA
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