Provider Demographics
NPI:1770397432
Name:BETHLEHEM PHARMACY RX INC
Entity type:Organization
Organization Name:BETHLEHEM PHARMACY RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SRIDEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAVIRISETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-915-4999
Mailing Address - Street 1:817 E 4TH ST FL1
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:817 E 4TH ST FL1
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015
Practice Address - Country:US
Practice Address - Phone:610-419-6522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy