MEDICARE: BEVERLY PLAZA RX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1336976760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY PLAZA RX INC

Provider Business Mailing Address
First Line	:	101 E BEVERLY BLVD STE 101
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4314
Country	:	US
Telephone Number	:	323-725-7155
Fax Number	:	323-725-7766

Provider Business Practice Location Address
First Line	:	101 E BEVERLY BLVD STE 101
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4314
Country	:	US
Telephone Number	:	323-725-7155
Fax Number	:	323-725-7766

Authorized Official
Title or Position	:	CEO
Name	:	MAIS MELIKIAN
Credential	:
Telephone Number	:	213-488-2080

Provider Enumeration Date	:	09/18/2024
Last Update Date	:	09/18/2024

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Directions to “BEVERLY PLAZA RX INC ” Practice Location

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