Provider Demographics
NPI:1720673858
Name:SHP BELLEVILLE LLC
Entity Type:Organization
Organization Name:SHP BELLEVILLE LLC
Other - Org Name:MIDPOINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHEDR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-969-1155
Mailing Address - Street 1:115 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1993
Mailing Address - Country:US
Mailing Address - Phone:973-969-1155
Mailing Address - Fax:973-969-1170
Practice Address - Street 1:115 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1993
Practice Address - Country:US
Practice Address - Phone:973-969-1155
Practice Address - Fax:973-969-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-01
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy