Provider Demographics
NPI:1366778532
Name:HMVN LLC
Entity type:Organization
Organization Name:HMVN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RX MANAGER / PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-4766
Mailing Address - Street 1:7230 US HIGHWAY 301 S
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4387
Mailing Address - Country:US
Mailing Address - Phone:813-443-7466
Mailing Address - Fax:813-443-7468
Practice Address - Street 1:7230 US HIGHWAY 301 S
Practice Address - Street 2:SUITE 1
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4387
Practice Address - Country:US
Practice Address - Phone:813-443-7466
Practice Address - Fax:813-443-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH243123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1050210OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL001888600Medicaid
FL001888601OtherMEDICAID DME
FL001888600Medicaid