Provider Demographics
NPI:1457753428
Name:NEW VISION PHARMACY PEARL LLC
Entity Type:Organization
Organization Name:NEW VISION PHARMACY PEARL LLC
Other - Org Name:HEALTHPLUS PHARMACY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BAROT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:617-270-6986
Mailing Address - Street 1:238 S PEARSON RD
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-5637
Mailing Address - Country:US
Mailing Address - Phone:601-914-4848
Mailing Address - Fax:601-292-7700
Practice Address - Street 1:238 S PEARSON RD
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-5637
Practice Address - Country:US
Practice Address - Phone:601-914-4848
Practice Address - Fax:601-292-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSF136413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS405425OtherPTAN
MS405425Medicare PIN