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General NPI Number Information
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NPI Number | 1831290840
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Entity Type | Organization
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Legal Business Name | B.B.W. DRUG CORPORATION
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 24031 MARGUERITE PKWY STE A
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1929
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Country | US
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Telephone | 949-586-1700
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Fax | 949-586-4683
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Provider Business Mailing Address
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Address Line | 24031 MARGUERITE PKWY STE A
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City | MISSION VIEJO
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State | CA
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Zip | 92692-1929
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Country | US
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Telephone | 949-586-1700
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Fax | 949-586-4683
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | DR. JOHN RICHARD BRUCE
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Credential | PHARMD
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Telephone | 949-586-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHY17089
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PHY17089
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | PHY17089
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY17089
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License Number State | CA
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