Provider Demographics
NPI:1306657762
Name:HEALTHVIA PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:HEALTHVIA PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-983-8700
Mailing Address - Street 1:300 GREENTREE RD STE 8E
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9418
Mailing Address - Country:US
Mailing Address - Phone:856-983-8700
Mailing Address - Fax:856-983-8703
Practice Address - Street 1:300 GREENTREE RD STE 8E
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9418
Practice Address - Country:US
Practice Address - Phone:856-983-8700
Practice Address - Fax:856-983-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0860999Medicaid