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General NPI Number Information
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NPI Number | 1770043234
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Entity Type | Organization
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Legal Business Name | BVP LLC
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 950 N HWY 414
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City | MOUNTAIN VIEW
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State | WY
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Zip | 82939
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Country | US
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Telephone | 307-782-3784
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Fax | 307-782-3785
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Provider Business Mailing Address
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Address Line | PO BOX 1699
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City | EVANSTON
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State | WY
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Zip | 82931
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Country | US
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Telephone | 307-782-3784
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Fax | 307-782-3785
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANDREW CANNON
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Credential | RPH
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Telephone | 307-789-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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