Provider Demographics
NPI:1023043544
Name:KRISHNA PHARMACY INC.
Entity Type:Organization
Organization Name:KRISHNA PHARMACY INC.
Other - Org Name:MEDCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BHUPESH
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:714-491-7472
Mailing Address - Street 1:1285 N EUCLID ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1954
Mailing Address - Country:US
Mailing Address - Phone:714-491-7472
Mailing Address - Fax:714-491-8673
Practice Address - Street 1:1285 N EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1954
Practice Address - Country:US
Practice Address - Phone:714-491-7472
Practice Address - Fax:714-491-8673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY444603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1023043544Medicaid
CA1295760001Medicare NSC