Organization
B P L P A PHARMACY CORPORATION
Active
Other names
Orange Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE IBRAHIM (CEO)
(909) 877-4224
Entity
Organization
Contact information
Practice address
2220 CLARK AVE, LONG BEACH, CA 90815-2521
(909) 877-4224
Mailing address
17691 SAN BERNARDINO AVE, FONTANA, CA 92335-5911
(909) 877-4224
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY 53860
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157232
PK
—
Enumeration date
12/29/2015
Last updated
03/29/2016
About Stedi
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