Provider Demographics
NPI:1295257053
Name:BHS PHARMACY LLC
Entity type:Organization
Organization Name:BHS PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:314-292-7388
Mailing Address - Street 1:763 S NEW BALLAS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8711
Mailing Address - Country:US
Mailing Address - Phone:314-292-7388
Mailing Address - Fax:314-292-7389
Practice Address - Street 1:763 S NEW BALLAS RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8711
Practice Address - Country:US
Practice Address - Phone:314-292-7388
Practice Address - Fax:314-292-7389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170063903336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1225475718OtherNPPES