Provider Demographics
NPI:1366451718
Name:BEDFORD PRESCRIPTION SERVICES
Entity type:Organization
Organization Name:BEDFORD PRESCRIPTION SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOVEE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:540-587-8700
Mailing Address - Street 1:309 N BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-1927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:309 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1927
Practice Address - Country:US
Practice Address - Phone:540-587-8700
Practice Address - Fax:540-586-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02001003724333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8504580Medicaid
4835902OtherOTHER ID NUMBER-COMMERCIAL NUMBER
VABT7082845OtherDEA #
VA1366451718Medicare NSC