Organization
HEALTHVILLE PHARMACY LLC
Active
Other names
HEALTHVILLE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEHINDE KELVIN BUSARI (PHARMACY MANAGER)
(956) 701-3349
Entity
Organization
Contact information
Practice address
7215 MCPHERSON RD, LAREDO, TX 78041
(956) 701-3349
(956) 701-3497
Mailing address
7215 MCPHERSON RD, LAREDO, TX 78041-6554
(956) 701-3349
(956) 701-3497
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
31006
TX
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149537
—
TX
Enumeration date
10/24/2016
Last updated
10/20/2023
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