Provider Demographics
NPI:1194289934
Name:BP6 LLC
Entity type:Organization
Organization Name:BP6 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SIDDARTHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ILANGOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM, MPHARM, RPH
Authorized Official - Phone:304-222-3064
Mailing Address - Street 1:104 S EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-4930
Mailing Address - Country:US
Mailing Address - Phone:304-222-3064
Mailing Address - Fax:304-253-3982
Practice Address - Street 1:360 MOUNT GAY RD
Practice Address - Street 2:
Practice Address - City:MOUNT GAY
Practice Address - State:WV
Practice Address - Zip Code:25637
Practice Address - Country:US
Practice Address - Phone:304-752-1445
Practice Address - Fax:304-752-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy