Bolsa Medical Mtm Pharma INC
Pharmacy, Community/Retail Pharmacy in Huntington Beach, CA. Organization (NPI-2).
Details
- NPI
- 1306372891
- Entity type
- Organization (NPI-2)
- Legal business name
- Bolsa Medical Mtm Pharma INC
- Organization subpart
- No
- Enumeration date
- May 3, 2017
- Certification date
- Apr 13, 2022
- Last updated
- Apr 13, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · DME SUPPLIER - PHARMACY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Mtm Pharmacy IV (Doing Business As)
Practice location
6552 Bolsa Ave Ste AHuntington Beach, CA 92647-2656
Phone 714-916-5383 · Fax 714-916-5384
Mailing address
6552 Bolsa AveSte A
Huntington Beach, CA 92647-2660
Phone 714-916-5383 · Fax 714-916-5384
Authorized official
Tina Tuyet Quach-Tran
President / Pharmacist In Charge
7149165383
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 38 Community/Retail Pharmacy providers in Huntington Beach · All 5,320 providers in Huntington Beach
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