Provider Demographics
NPI:1023051802
Name:BESTCARE PHARMACY INC
Entity type:Organization
Organization Name:BESTCARE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MY DOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THI VO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-856-3667
Mailing Address - Street 1:17573 LIVE OAK CIR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4413
Mailing Address - Country:US
Mailing Address - Phone:714-856-3667
Mailing Address - Fax:
Practice Address - Street 1:2220 CLARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2521
Practice Address - Country:US
Practice Address - Phone:562-494-1371
Practice Address - Fax:562-494-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X, 333600000X
CAPHY472323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5617040OtherNCPDP PROVIDER IDENTIFICATION NUMBER