Organization
BW ONE INC
Active
Other names
BIG 1 Pharmacy LA
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WU (PHARMD)
(213) 617-7888
Entity
Organization
Contact information
Practice address
656 N BROADWAY, LOS ANGELES, CA 90012-2802
(213) 617-7888
(213) 617-7241
Mailing address
656 N BROADWAY, LOS ANGELES, CA 90012-2801
(213) 617-7888
(213) 617-7241
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY53655
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2126411
PK
—
05
—
PHA503880
—
CA
Enumeration date
08/25/2005
Last updated
07/19/2018
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