Provider Demographics
NPI:1992943310
Name:TVPHARMACIST LLC
Entity type:Organization
Organization Name:TVPHARMACIST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PREDSIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-421-8267
Mailing Address - Street 1:9011 PARK BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33777-4123
Mailing Address - Country:US
Mailing Address - Phone:727-398-1492
Mailing Address - Fax:727-342-5850
Practice Address - Street 1:9011 PARK BLVD STE 206
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4123
Practice Address - Country:US
Practice Address - Phone:727-398-1492
Practice Address - Fax:727-342-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336H0001X
FLPH237663336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1041780OtherNCPDP PROVIDER IDENTIFICATION NUMBER