Provider Demographics
NPI:1851591200
Name:JVHD LLC
Entity Type:Organization
Organization Name:JVHD LLC
Other - Org Name:KERMIT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-266-1912
Mailing Address - Street 1:810 MYER LN
Mailing Address - Street 2:
Mailing Address - City:KERMIT
Mailing Address - State:TX
Mailing Address - Zip Code:79745
Mailing Address - Country:US
Mailing Address - Phone:432-586-2556
Mailing Address - Fax:432-586-5934
Practice Address - Street 1:810 MYER LN
Practice Address - Street 2:
Practice Address - City:KERMIT
Practice Address - State:TX
Practice Address - Zip Code:79745
Practice Address - Country:US
Practice Address - Phone:432-586-2556
Practice Address - Fax:432-586-5934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28298333600000X
333600000X
NMPH00034453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM15528006Medicaid
TX146706Medicaid
2136629OtherPK