Baiden Group Inc
Organization Active NPI Community/Retail Pharmacy · Acton, CA
NPI 1124393616 · NPPES record last updated Apr 8, 2022
Key facts
- NPI
- 1124393616
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY50825 (CA)
- Legal business name
- BAIDEN GROUP INC
- Practice address
- 3630 Smith Ave
Ste a
Acton, CA 93510-2500 - Phone
- (661) 269-9911
- Fax
- (661) 269-9915
- NPI assigned
- Mar 15, 2012
- Organization subpart
- No
Authorized official
- Name
- Amma Amihyia
- Title
- Owner
- Phone
- (661) 269-9911
Practitioners 1
-
Amma Busumafi Amihyia, PHARM.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190906001730 | CA | DME Supplier - Pharmacy | 7911106455 | Practice locations: Acton, CA |
National Provider Directory
Locations
3630 Smith Ave
Ste A
Acton, CA 93510
Phone (661) 269-9911
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY50825 | CA | Yes |
Addresses
Primary practice location
3630 Smith Ave
Ste a
Acton, CA 93510-2500
Mailing address
3630 Smith Ave
Ste a
Acton, CA 93510-2500
Phone (661) 269-9911
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124393616 | Medicaid | CA | |
| 2134360 | Other | PK |
Other names
- ACTON VALE PHARMACY
Other providers in Acton, CA
- Darian Alyssa Alfaro
- Amma Busumafi Amihyia
- Antelope Valley Rehabilitation Centers Residential
- Autumn Arnold
- Monica Isabel Axume
- Baiden Group Inc
- Paula Balfour
- Deborah Ann Benz
- Elena Bigun
- Bright Mission Recovery
All providers in Acton, CA · Community/Retail Pharmacy in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.