Provider Demographics
NPI:1396418315
Name:APOTHECO PHARMACY BELLEVUE LLC
Entity type:Organization
Organization Name:APOTHECO PHARMACY BELLEVUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-241-3048
Mailing Address - Street 1:788 MORRIS TURNPIKE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-869-2820
Mailing Address - Fax:973-869-2822
Practice Address - Street 1:339 KIRKLAND AVENUE
Practice Address - Street 2:SUITE G
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033
Practice Address - Country:US
Practice Address - Phone:425-364-9227
Practice Address - Fax:425-300-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604749321OtherCERTIFICATE OF FORMATION