BJRX Pharmacy LTC Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

PHY 53617 Issued in CA

Legal business name

BJRX PHARMACY LTC INC

Doing business as

BJRX Pharmacy LTC, Inc.

Practice address

1801 E March LN # 270
Stockton, CA 95210-6629

Phone

(209) 451-3171

Fax

(209) 451-3635

NPI assigned

Oct 1, 2015

Last updated

Mar 30, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pratap AnneNPI 1699911412

Title

Director

Phone

(209) 474-3888

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BJRX PHARMACY LTC, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Tax ID family

BJRX Pharmacy LTC Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stockton Pharmacy

  • Home Infusion Therapy Pharmacy
  • Stockton, CA
  • NPI 1417891953
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Stockton Pharmacy

  • Home Infusion Therapy Pharmacy
  • Stockton, CA
  • NPI 1417891953
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pratap Krishna Anne, RPH

  • Pharmacist
  • Stockton, CA
  • NPI 1699911412
  NPD (past) Authorized official
• Sravani Sagireddy, DO

  • Family Medicine Physician
  • Rancho Cordova, CA
  • NPI 1467197293
  NPD
• Nabeela Taher Khan

  • Pharmacist
  • Stockton, CA
  • NPI 1114751443
  NPD (past)
• Anuradha Ravi

  • Pharmacist
  • Stockton, CA
  • NPI 1518613801
  NPD (past)
• Michael Agcaoili Yadao, PHARMD

  • Pharmacist
  • Stockton, CA
  • NPI 1922684786
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1073983144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE:B270",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-474-3888",
            "fax_number": "209-474-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN # 270",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-451-3171",
            "fax_number": "209-451-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BJRX PHARMACY LTC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "ANNE",
        "authorized_official_first_name": "PRATAP",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "209-474-3888"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "PHY 53617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154419",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BJRX PHARMACY LTC, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Robert Bishop
• Lorraine Elizabeth Bishop
• Troymera Bishop
• Karen B. Bissell, MD
• BJRX Pharmacy Inc
• Gregory Black, PT, OCS
• Nicolas Andrew Black
• Pamela Black
• Tracey Black
• Wilnika Lanima Black

• Long Term Care Pharmacy in Stockton, CA
• Providers in Stockton, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.