Provider Demographics
NPI:1144772476
Name:MECHANICSVILLE CHEMIST LLC
Entity Type:Organization
Organization Name:MECHANICSVILLE CHEMIST LLC
Other - Org Name:BELL CREEK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PIC, AO
Authorized Official - Prefix:
Authorized Official - First Name:BHUPENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-635-8654
Mailing Address - Street 1:8324 BELL CREEK RD STE 800
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-3849
Mailing Address - Country:US
Mailing Address - Phone:757-635-8654
Mailing Address - Fax:804-277-4135
Practice Address - Street 1:8324 BELL CREEK RD STE 800
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3849
Practice Address - Country:US
Practice Address - Phone:804-277-8938
Practice Address - Fax:804-277-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
VA02010047403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2165918OtherPK