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General NPI Number Information
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NPI Number | 1194221762
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Entity Type | Organization
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Legal Business Name | BK PHARMACY CORP
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 04/03/2018
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Provider Practice Location Address
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Address Line | 7509 N WILLOW AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93720-0345
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Country | US
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Telephone | 559-325-6581
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Fax | 559-325-6627
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Provider Business Mailing Address
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Address Line | 7509 N WILLOW AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93720-0345
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Country | US
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Telephone | 559-438-9888
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Fax | 559-438-0118
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHELDON KONG
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Credential |
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Telephone | 559-438-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 56093
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License Number State | CA
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