Provider Demographics
NPI:1912194846
Name:KSV HEALTHCARE LLC
Entity Type:Organization
Organization Name:KSV HEALTHCARE LLC
Other - Org Name:THE PHARMACY NORTHSHIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-362-0390
Mailing Address - Street 1:205 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-1829
Mailing Address - Country:US
Mailing Address - Phone:802-442-5602
Mailing Address - Fax:802-442-8023
Practice Address - Street 1:34 WAYS LN
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9231
Practice Address - Country:US
Practice Address - Phone:802-362-0390
Practice Address - Fax:802-367-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6017430001Medicare NSC