Organization
BEVERLY PROFESSIONAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHESH PATEL (OWNER/PHARMACIST)
(323) 728-0248
Entity
Organization
Contact information
Practice address
433 N 4TH ST STE 100, MONTEBELLO, CA 90640-4313
(323) 728-0248
(323) 728-9099
Mailing address
433 N 4TH ST, SUITE 100, MONTEBELLO, CA 90640-4399
(323) 728-0248
(323) 728-9099
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY33172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2066032
PK
—
05
—
PHA331720
—
CA
Enumeration date
08/31/2006
Last updated
01/09/2018
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