Provider Demographics
NPI:1154615128
Name:BEHAVIORAL HEALTH PHARMACY INNOVATIONS, LLC
Entity type:Organization
Organization Name:BEHAVIORAL HEALTH PHARMACY INNOVATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER / PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MARROTTA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:910-859-8211
Mailing Address - Street 1:2033 CORPORATE DR STE B2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-7464
Mailing Address - Country:US
Mailing Address - Phone:910-859-8211
Mailing Address - Fax:910-228-5843
Practice Address - Street 1:2033 CORPORATE DR
Practice Address - Street 2:STE B2
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-7464
Practice Address - Country:US
Practice Address - Phone:910-859-8211
Practice Address - Fax:910-228-5843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy