B P L P a Pharmacy Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY53649 Issued in CA

Legal business name

B P L P A PHARMACY CORPORATION

Practice address

12730 Heacock St Ste 1
Moreno Valley, CA 92553-3040

Phone

(951) 924-4990

Fax

(951) 924-4992

NPI assigned

Jul 18, 2015

Organization subpart

No

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

Authorized official

Name

George Ibrahim

Title

Owner, Ao

Phone

(909) 877-4224

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Orange Express Pharmacy Doing business as

Tax ID family

B P L P a Pharmacy Corporation2 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.

• B P L P a Pharmacy Corporation

  • Community/Retail Pharmacy
  • Long Beach, CA
  • NPI 1346605706
  NPD tax ID

Locations

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1831573963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PASEO GRANDE",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823702",
            "telephone_number": "499-232-4215",
            "fax_number": "951-924-4992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 HEACOCK ST STE 1",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533040",
            "telephone_number": "951-924-4990",
            "fax_number": "951-924-4992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B P L P A PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER,  AO",
        "authorized_official_telephone_number": "909-877-4224"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY53649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831573963",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2154167",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orange Express Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Idowu Ayinla, MANAGING TECHNICIAN
• Shuja Ayouby, DO
• Armaghan Azad, M.D.
• Azar Foot & Ankle Specialist
• Chisomaga Azu
• B. Deirmenjian, DDS, Inc
• Cindy Bach
• Sharon Bacot Carter, NP
• Alma Y. Baeza, LMFT
• Aniyah Renee Bagley

• Community/Retail Pharmacy in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.