Provider Demographics
NPI:1366855512
Name:BTN ORANGE PHARMACY
Entity Type:Organization
Organization Name:BTN ORANGE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BICH-HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:BUI-TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:626-214-2562
Mailing Address - Street 1:140 NORTH ORANGE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790
Mailing Address - Country:US
Mailing Address - Phone:626-214-2562
Mailing Address - Fax:
Practice Address - Street 1:140 NORTH ORANGE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790
Practice Address - Country:US
Practice Address - Phone:626-214-2562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BTN PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA518563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy