Provider Demographics
NPI:1720090111
Name:BEST VALUE PHARMACIES INC
Entity Type:Organization
Organization Name:BEST VALUE PHARMACIES INC
Other - Org Name:BEST VALUE RIDGLEA DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-727-6655
Mailing Address - Street 1:5932 LOVELL AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-5030
Mailing Address - Country:US
Mailing Address - Phone:817-287-8125
Mailing Address - Fax:817-737-2722
Practice Address - Street 1:5932 LOVELL AVE
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-5030
Practice Address - Country:US
Practice Address - Phone:817-737-6655
Practice Address - Fax:817-737-5018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX132913336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2104133OtherPK
TX470835Medicaid
1157300008Medicare NSC