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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