MEDICARE: BKNC PHARMACIES 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	3336C0003X	Community/Retail Pharmacy	PHY48194	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5623360	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407950454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BKNC PHARMACIES INC

Provider Business Mailing Address
First Line	:	555 W COMPTON BLVD
Second Line	:	STE 102
City	:	COMPTON
State	:	CA
Zip	:	90220-3085
Country	:	US
Telephone Number	:	310-537-2337
Fax Number	:	310-537-2359

Provider Business Practice Location Address
First Line	:	555 W COMPTON BLVD
Second Line	:	STE 102
City	:	COMPTON
State	:	CA
Zip	:	90220-3085
Country	:	US
Telephone Number	:	310-537-2337
Fax Number	:	310-537-2359

Authorized Official
Title or Position	:	PHCY TECH
Name	:	BHARAT GANDHI
Credential	:
Telephone Number	:	562-676-8138

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	09/15/2010

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Directions to “BKNC PHARMACIES INC ” Practice Location

Language	Start Address	Practice Location

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