Provider Demographics
NPI:1316021199
Name:VEVI PHARMACY INC
Entity Type:Organization
Organization Name:VEVI PHARMACY INC
Other - Org Name:BARTH'S DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BHASKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNJUPALI
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM
Authorized Official - Phone:631-727-2125
Mailing Address - Street 1:32 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2423
Mailing Address - Country:US
Mailing Address - Phone:631-727-2125
Mailing Address - Fax:631-727-2199
Practice Address - Street 1:32 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2423
Practice Address - Country:US
Practice Address - Phone:631-727-2125
Practice Address - Fax:631-727-2199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0343703336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00625365Medicaid
NY034370OtherSTATE LICENSE
33-06948OtherNCPDP
33-06948OtherNCPDP