Provider Demographics
NPI:1821000852
Name:B2TF LTC PHARMACY LLC
Entity Type:Organization
Organization Name:B2TF LTC PHARMACY LLC
Other - Org Name:B2TF PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAVIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:903-756-8741
Mailing Address - Street 1:403 NORTH KAUFMAN STREET
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TX
Mailing Address - Zip Code:75563
Mailing Address - Country:US
Mailing Address - Phone:903-756-8741
Mailing Address - Fax:903-756-8741
Practice Address - Street 1:403 NORTH KAUFMAN STREET
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TX
Practice Address - Zip Code:75563-5234
Practice Address - Country:US
Practice Address - Phone:903-756-8741
Practice Address - Fax:903-756-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX206473336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350160Medicaid