Provider Demographics
NPI:1003213927
Name:BET PHARM, LLC
Entity Type:Organization
Organization Name:BET PHARM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-273-2930
Mailing Address - Street 1:1501 BULL LEA RD
Mailing Address - Street 2:SUITE 102B
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-1285
Mailing Address - Country:US
Mailing Address - Phone:859-273-2930
Mailing Address - Fax:859-273-2860
Practice Address - Street 1:1501 BULL LEA RD
Practice Address - Street 2:SUITE 102B
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1285
Practice Address - Country:US
Practice Address - Phone:859-273-2930
Practice Address - Fax:859-273-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP068143336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy