Organization
BLUE HAVEN VENTURES, LLC
Active
Organization
BLUE HAVEN VENTURES, LLC
Active
Other names
Blue Haven Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTO ROLANDO OLIVARES PHARMACIST (MANAGING MEMBER/PRESIDENT)
(512) 693-4222
Entity
Organization
Contact information
Practice address
5625 EIGER RD STE 150, AUSTIN, TX 78735-8980
(512) 693-4222
(512) 487-5311
Mailing address
5625 EIGER RD STE 150, AUSTIN, TX 78735-8980
(512) 693-4222
(512) 487-5311
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31459
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
06/19/2017
Last updated
06/29/2017
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