Provider Demographics
NPI:1518100916
Name:BGS PHARMACY LLC
Entity Type:Organization
Organization Name:BGS PHARMACY LLC
Other - Org Name:VALUE CENTER PHARMACY I
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MURALI
Authorized Official - Middle Name:C
Authorized Official - Last Name:GINJUPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-906-4232
Mailing Address - Street 1:37155 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:37155 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3013
Practice Address - Country:US
Practice Address - Phone:586-954-9100
Practice Address - Fax:586-954-9109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2022-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010091003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2119866OtherPK
2119866OtherPK