Provider Demographics
NPI:1225871767
Name:BOBS PHARMACY LLC
Entity type:Organization
Organization Name:BOBS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:GIRIDHAR
Authorized Official - Middle Name:V
Authorized Official - Last Name:ATHMAKURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-732-6915
Mailing Address - Street 1:430 BLEECKER ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-2336
Mailing Address - Country:US
Mailing Address - Phone:315-732-6915
Mailing Address - Fax:315-732-6641
Practice Address - Street 1:430 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2336
Practice Address - Country:US
Practice Address - Phone:315-732-6915
Practice Address - Fax:315-732-6641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy