=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083963060
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BC PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2012
-----------------------------------------------------
Last Update Date | 03/27/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14030 TELGE RD STE E
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-6201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-334-5695
-----------------------------------------------------
Fax | 832-334-5903
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14030 TELGE RD SUITE E
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-6200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-334-5695
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | IHEOMA CHIKWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-334-5695
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0004X
-----------------------------------------------------
Taxonomy Name | Compounding Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 28222
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------