Healthcare Provider Details

I. General information

NPI: 1124580998
Provider Name (Legal Business Name): BVM ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 02/23/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 STREET ROAD
BENSALEM PA
19020
US

IV. Provider business mailing address

1941 STREET RD
BENSALEM PA
19020-4380
US

V. Phone/Fax

Practice location:
  • Phone: 215-638-0000
  • Fax: 215-638-0001
Mailing address:
  • Phone: 215-638-0000
  • Fax: 215-638-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SIMA PATEL
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 215-638-0000