Provider Demographics
NPI:1083779680
Name:BPTN, LLC
Entity Type:Organization
Organization Name:BPTN, LLC
Other - Org Name:HEALTH ONE PHARMACY OF OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT,CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PINKERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-953-0604
Mailing Address - Street 1:34099 MELINZ PKWY
Mailing Address - Street 2:UNIT G
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4041
Mailing Address - Country:US
Mailing Address - Phone:440-953-0604
Mailing Address - Fax:
Practice Address - Street 1:34099 MELINZ PKWY
Practice Address - Street 2:UNIT G
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-4041
Practice Address - Country:US
Practice Address - Phone:440-953-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-15013503336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2528330Medicaid
OH3673250OtherNABP NUMBER
OH02-1501350OtherSTATE LICENSE
OH02-1501350OtherSTATE LICENSE