Provider Demographics
NPI:1538257597
Name:BB PHARMS, INC.
Entity type:Organization
Organization Name:BB PHARMS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-503-9799
Mailing Address - Street 1:174 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36322-2306
Mailing Address - Country:US
Mailing Address - Phone:334-503-9799
Mailing Address - Fax:334-503-9919
Practice Address - Street 1:174 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36322-2306
Practice Address - Country:US
Practice Address - Phone:334-503-9799
Practice Address - Fax:334-503-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009971455Medicaid
AL0131918OtherNCPDP
1538257597OtherNPI
AL100003495Medicaid
AL0131918OtherNCPDP
ALC08406620Medicare PIN