Provider Demographics
NPI:1790949014
Name:BVM PHARMACY LLC
Entity Type:Organization
Organization Name:BVM PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:HARESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-748-2449
Mailing Address - Street 1:254 E JIMMIE LEEDS RD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9567
Mailing Address - Country:US
Mailing Address - Phone:609-748-2449
Mailing Address - Fax:609-748-0959
Practice Address - Street 1:254 E JIMMIE LEEDS RD UNIT 1
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9567
Practice Address - Country:US
Practice Address - Phone:609-748-2449
Practice Address - Fax:609-748-0959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3195181OtherNCPDP #
NJ0149471Medicaid
NJ0149471Medicaid