Organization
BSDS, INC.
Active
Organization
BSDS, INC.
Active
Other names
Bause's Super Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY L MELLOTT R.PH. (PHARMACIST MANAGER)
(610) 367-8641
Entity
Organization
Contact information
Practice address
42 E PHILADELPHIA AVE, BOYERTOWN, PA 19512-1125
(610) 367-8641
(610) 369-0945
Mailing address
42 E PHILADELPHIA AVE, BOYERTOWN, PA 19512-1125
(610) 367-8641
(610) 369-0945
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP410131L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001210316-0001
—
PA
01
—
3960413
NABP
PA
Enumeration date
05/31/2006
Last updated
07/15/2008
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