Provider Demographics
NPI:1336976760
Name:BEVERLY PLAZA RX INC
Entity type:Organization
Organization Name:BEVERLY PLAZA RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-488-2080
Mailing Address - Street 1:101 E BEVERLY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4314
Mailing Address - Country:US
Mailing Address - Phone:323-725-7155
Mailing Address - Fax:323-725-7766
Practice Address - Street 1:101 E BEVERLY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4314
Practice Address - Country:US
Practice Address - Phone:323-725-7155
Practice Address - Fax:323-725-7766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy