Provider Demographics
NPI:1497769343
Name:BIOCARE RX SPECIALTY PHARMACY LLC
Entity Type:Organization
Organization Name:BIOCARE RX SPECIALTY PHARMACY LLC
Other - Org Name:BIOCARE RX SPECIALTY PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-382-3500
Mailing Address - Street 1:5435 BALBOA BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1508
Mailing Address - Country:US
Mailing Address - Phone:818-382-3500
Mailing Address - Fax:818-382-3501
Practice Address - Street 1:5435 BALBOA BLVD
Practice Address - Street 2:STE 210
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1508
Practice Address - Country:US
Practice Address - Phone:818-382-3500
Practice Address - Fax:818-382-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY475543336C0003X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2115017OtherPK
2115017OtherPK
4364737Medicare PIN