Provider Demographics
NPI:1467926717
Name:BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Entity type:Organization
Organization Name:BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-830-8820
Mailing Address - Street 1:PO BOX 162088
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32716-2088
Mailing Address - Country:US
Mailing Address - Phone:866-514-8082
Mailing Address - Fax:
Practice Address - Street 1:4900 PROSPECTUS DR STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4407
Practice Address - Country:US
Practice Address - Phone:866-514-8082
Practice Address - Fax:833-664-4926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-18
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1467926717Medicaid