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General NPI Number Information
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NPI Number | 1821021809
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Entity Type | Organization
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Legal Business Name | BELLEVUE PHARMACY, INC
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 4038 MACARTHUR AVE
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City | RICHMOND
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State | VA
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Zip | 23227
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Country | US
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Telephone | 804-264-0458
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Fax | 804-264-4588
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Provider Business Mailing Address
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Address Line | PO BOX 653
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City | MIDLOTHIAN
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State | VA
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Zip | 23114
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Country | US
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Telephone | 804-264-0458
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Fax | 804-264-4588
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. LORENZO T. MURRAY JR.
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Credential | RPH
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Telephone | 804-264-0458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 0201003214
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License Number State | VA
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