Provider Demographics
NPI:1376846436
Name:BEDB PHARMACIES LLC
Entity Type:Organization
Organization Name:BEDB PHARMACIES LLC
Other - Org Name:OAKLAND TERRACE APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RX MGR
Authorized Official - Prefix:
Authorized Official - First Name:STU
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-485-1099
Mailing Address - Street 1:2629 WEST OAKLAND
Mailing Address - Street 2:PARK BLVD
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311
Mailing Address - Country:US
Mailing Address - Phone:954-485-1099
Mailing Address - Fax:954-832-9143
Practice Address - Street 1:2629 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1355
Practice Address - Country:US
Practice Address - Phone:954-485-1099
Practice Address - Fax:954-832-9143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336C0004X
FLPH250723336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5703031OtherNCPDP PROVIDER IDENTIFICATION NUMBER