1427385053 NPI number — BV PHARMACY DEVELOPMENT INC

Table of content: (NPI 1427385053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427385053 NPI number — BV PHARMACY DEVELOPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BV PHARMACY DEVELOPMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ROSENBERG 9 PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427385053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7211 PORT ALEXANDER WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77083-3951
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-857-4930
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4114 AVENUE H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSENBERG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77471-2833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-762-0874
Provider Business Practice Location Address Fax Number:
281-762-0877
Provider Enumeration Date:
11/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
OANH
Authorized Official First Name:
NGUYEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
281-762-0874

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  26667 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 14610 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2122426 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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