Balboa Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BALBOA PHARMACY LLC

Practice address

780 5TH Ave Ste 160
King of Prussia, PA 19406-1463

Phone

(650) 353-5495

NPI assigned

Jun 21, 2021

Organization subpart

No

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

Authorized official

Name

Mohammad Afridi

Title

Officere

Phone

(650) 353-5495

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1972172450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 5TH AVE STE 160",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 5TH AVE STE 160",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061463",
            "telephone_number": "650-353-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALBOA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "AFRIDI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OFFICERE",
        "authorized_official_telephone_number": "650-353-5495"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew A Badulak, DO
• Masuma Bahora, MD
• Carli Bailey
• Jennie Odessa Balan
• Balance and Vestibular Center of King of Prussia LLC
• Emma Rose Ball, M.S., CF-SLP
• Matthew James Ballas, DMD
• April Balobalo
• Michael Baniewicz, PSY.D.
• Julianne Baratta, DPT

• Community/Retail Pharmacy in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.