Provider Demographics
NPI:1174021778
Name:B7 PHARMACY INC
Entity Type:Organization
Organization Name:B7 PHARMACY INC
Other - Org Name:GOOD VALUE PHARMACY RACINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:BERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:262-658-8124
Mailing Address - Street 1:3825 39TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144
Mailing Address - Country:US
Mailing Address - Phone:262-658-8124
Mailing Address - Fax:262-564-8667
Practice Address - Street 1:5220 WASHINGTON AVE # 101
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-4228
Practice Address - Country:US
Practice Address - Phone:262-632-6561
Practice Address - Fax:262-632-6505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B7 PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9494-423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy