Provider Demographics
NPI:1588928402
Name:BIG 8 PHARMACY INC
Entity type:Organization
Organization Name:BIG 8 PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-851-8108
Mailing Address - Street 1:4318 MAINE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-3326
Mailing Address - Country:US
Mailing Address - Phone:626-851-8108
Mailing Address - Fax:626-960-9840
Practice Address - Street 1:4318 MAINE AVE STE C
Practice Address - Street 2:
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-3326
Practice Address - Country:US
Practice Address - Phone:626-851-8108
Practice Address - Fax:626-960-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-26
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA537163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6794030001Medicare NSC