MEDICARE: BT ENTERPRISES

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PP482312	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2136390	OTHER		PK

General Provider Information

NPI Number	:	1861749806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BT ENTERPRISES

Provider Business Mailing Address
First Line	:	5466 SPRUCE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-4060
Country	:	US
Telephone Number	:	215-747-4700
Fax Number	:	215-747-4701

Provider Business Practice Location Address
First Line	:	5466 SPRUCE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-4060
Country	:	US
Telephone Number	:	215-747-4700
Fax Number	:	215-747-4701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BAO TRAN
Credential	:	PHARMD
Telephone Number	:	215-747-4700

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	06/21/2016

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Directions to “BT ENTERPRISES ” Practice Location

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