MEDICARE: BP PHARMACY, 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

General Provider Information

NPI Number	:	1841751856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BP PHARMACY, INC.

Provider Business Mailing Address
First Line	:	6726 BEACH BLVD
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-3410
Country	:	US
Telephone Number	:	714-752-6698
Fax Number	:	714-752-6538

Provider Business Practice Location Address
First Line	:	6726 BEACH BLVD
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90621-3410
Country	:	US
Telephone Number	:	714-752-6698
Fax Number	:	714-752-6538

Authorized Official
Title or Position	:	OWNER
Name	:	HYUNG SEOK KIM
Credential	:
Telephone Number	:	714-752-6698

Provider Enumeration Date	:	03/31/2019
Last Update Date	:	03/31/2019

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