MEDICARE: B.V.M. PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	30081	TX

General Provider Information

NPI Number	:	1528371424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B.V.M. PHARMACY INC.

Provider Business Mailing Address
First Line	:	9325 KEMPWOOD DR STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-2813
Country	:	US
Telephone Number	:	713-460-5100
Fax Number	:	713-460-5101

Provider Business Practice Location Address
First Line	:	9325 KEMPWOOD DR STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77080-2813
Country	:	US
Telephone Number	:	713-460-5100
Fax Number	:	713-460-5101

Authorized Official
Title or Position	:	P.I.C.
Name	:	MS. MONICA B. TRIPLETT
Credential	:	R.PH.
Telephone Number	:	979-241-2741

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	07/20/2010

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