BBN Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BBN PHARMACY INC

Doing business as

Spring Park Pharmacy

Practice address

6226 E Spring St Ste 140
Long Beach, CA 90815-1441

Phone

(562) 420-1303

Fax

(562) 429-9271

NPI assigned

Jul 30, 2006

Last updated

Nov 12, 2024By 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

Junelyn BautistaNPI 1558901017

Title

President

Phone

(562) 420-1303

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• SPRING PARK PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Med Matrix Pharmacy, Inc

  dba Med Care Pharmacy

  • Community/Retail Pharmacy
  • Vista, CA
  • NPI 1093795577

  6901212919

  Same PAC ID

Locations

Practitioners 2

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.

• Junelyn Bantad Bautista

  • Pharmacist
  • Long Beach, CA
  • NPI 1558901017
  NPD Authorized official
• Nicholas Alexander Ariaz

  • Pharmacist
  • Aliso Viejo, CA
  • NPI 1649144197
  NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1902811524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 140",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151441",
            "telephone_number": "310-420-1303",
            "fax_number": "310-429-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 E SPRING ST STE 140",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151441",
            "telephone_number": "562-420-1303",
            "fax_number": "562-429-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BBN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "JUNELYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-420-1303"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY36892",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0505670",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA368920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPRING PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SPRING PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Long Beach, CA
• Providers in Long Beach, 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 Nov 12, 2024; 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.