Fairfax Pharmacy

LBN: Bdo Corporation
Fairfax Pharmacy is an health care organization with primary practice located at 1111 N Fairfax Ave Ste 110 , West Hollywood CA 90046-5363. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Bdo Corporation can be contacted via phone (323) 656-9622, or through Vayberman, Gregory via phone (323) 565-8622.

Contact Information

Primary practice address
1111 N Fairfax Ave Ste 110 West Hollywood CA 90046-5363
Phone: (323) 656-9622
Fax: (323) 656-9718
Website:
Map and Directions
Authorized official contact:
Name: Vayberman, Gregory
Phone: (323) 565-8622

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY41877 California
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1144220492
LBN Legal business name Bdo Corporation
DBA Doing business as Fairfax Pharmacy
Authorized official Vayberman, Gregory
Entity Organization
Organization subpart 1 No
Enumeration date Jul 28th, 2005
Last updated Feb 27th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144220492 NPPES
California MEDICAID PHA418770
California Other 1994763

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