Provider Demographics
NPI:1790911899
Name:HELIE, LLC
Entity Type:Organization
Organization Name:HELIE, LLC
Other - Org Name:NORTHERN BEDFORD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:BRETON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:814-766-0124
Mailing Address - Street 1:3499 BRUMBAUGH RD
Mailing Address - Street 2:
Mailing Address - City:NEW ENTERPRISE
Mailing Address - State:PA
Mailing Address - Zip Code:16664
Mailing Address - Country:US
Mailing Address - Phone:814-766-0124
Mailing Address - Fax:814-766-0126
Practice Address - Street 1:3499 BRUMBAUGH RD
Practice Address - Street 2:
Practice Address - City:NEW ENTERPRISE
Practice Address - State:PA
Practice Address - Zip Code:16664
Practice Address - Country:US
Practice Address - Phone:814-766-0124
Practice Address - Fax:814-766-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4819193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023426800001Medicaid