Provider Demographics
NPI:1760828149
Name:BLUE HILL PHARMACY LLC
Entity Type:Organization
Organization Name:BLUE HILL PHARMACY LLC
Other - Org Name:BLUE HILL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:339-987-0167
Mailing Address - Street 1:320 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02121-1951
Mailing Address - Country:US
Mailing Address - Phone:339-987-0167
Mailing Address - Fax:
Practice Address - Street 1:320 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02121-1951
Practice Address - Country:US
Practice Address - Phone:339-987-0167
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy