Provider Demographics
NPI:1346251832
Name:BHARAT CORP
Entity Type:Organization
Organization Name:BHARAT CORP
Other - Org Name:ST LOUIS DRUG COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:RAJENDRAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-268-6819
Mailing Address - Street 1:2100 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-3918
Mailing Address - Country:US
Mailing Address - Phone:323-268-6819
Mailing Address - Fax:323-268-8018
Practice Address - Street 1:2100 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-3918
Practice Address - Country:US
Practice Address - Phone:323-268-6819
Practice Address - Fax:323-268-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY343053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1999041OtherPK
CAPHA343050Medicaid