BLUE HAVEN VENTURES, LLC (NPI# 1699205971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699205971 |
| Entity Type | Organization |
| Organization Name | BLUE HAVEN VENTURES, LLC |
| Other Organization Name | BLUE HAVEN PHARMACY |
| Practice Address |
5625 Eiger Rd Ste 150 Austin TX 78735-8980 |
| Practice Telephone | 5126934222 |
| Practice Fax Number | 5124875311 |
| Mailing Telephone | 5126934222 |
| Mailing Fax Number | 5124875311 |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2017-06-29 |
| Authorized Official Name | ROBERTO ROLANDO OLIVARES (MANAGING MEMBER/PRESIDENT) |
| Authorized Official Telephone | 5126934222 |
| Authorized Official Credential | PHARMACIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
31459 | TX | Suppliers |
| Other Name | Type Code |
|---|---|
| Blue Haven Pharmacy | Doing Business As Name - Organization |
| Street Address |
5625 EIGER RD STE 150 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78735-8980 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912291204 | Roberto Rolando Olivares | Pharmacist | 5625 Eiger Rd Ste 150, Austin, TX 78735-8980 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959748 | Si Shou Acupuncture and Wellness, Pllc | Acupuncturist | 5424 W Us Hwy 290 Service Rd, Ste #106, Austin, TX 78735 | 2020-07-10 |
| 1982221115 | Andrea Fackler | Counselor | 4425 S. Mopac Expressway, Building 3, Suite 503, Austin, TX 78735 | 2020-07-03 |
| 1134763162 | Amanda Enzbigilis | Physical Therapist | 5251 W Us Highway 290, Austin, TX 78735 | 2019-11-02 |
| 1427616408 | Soco Psychotherapy, Inc | Counselor | 4425 Mopac Expressway South, Bldg II, Suite 204, Austin, TX 78735 | 2019-06-04 |
| 1306306154 | Kelly Bolerjack | Doula | 4400 Twisted Tree Drive, Austin, TX 78735 | 2019-03-20 |
| 1407362619 | Sara Katherine Paules | Counselor | 4425 South Mopac Expy, Suite 502, Austin, TX 78735 | 2017-12-26 |
| 1851806418 | Circle Medical Care of Texas P. A. | Internal Medicine | 5424 W. Us Hwy 290, 101, Austin, TX 78735 | 2017-12-05 |
| 1699293266 | Derek Kalvin Vo | Dentist | 7612 W Highway 71 Ste B, Austin, TX 78735 | 2017-09-05 |
| 1588189013 | Rachel Caroline Boraten | Audiologist | 5625 Eiger Rd Ste 125, Austin, TX 78735 | 2017-08-05 |
| 1669908489 | Lesley Caldwell Ma Lpc Pllc | Counselor | 4425 South Mopac Expy., Building IIi, Suite 603, Austin, TX 78735 | 2017-05-11 |
| Find all providers in zip 78735 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1801494018 | 340b Partners Pharmacy - Dallas LLC | Pharmacy | 2800 S Ih 35 Frontage Rd, Suite 105, Austin, TX 78704 | 2020-10-12 |
| 1942817911 | Vivent Pharmacy LLC | Pharmacy | 7215 Cameron Rd Ste B, Austin, TX 78752-2911 | 2020-09-24 |
| 1649885195 | Rocket Pharmacy, Inc. | Pharmacy | 316 W 12th St Ste Ll050, Austin, TX 78701-1815 | 2020-09-11 |
| 1831737642 | Cvs Pharmacy, Inc | Pharmacy | 901 East 5 Th St, Suite 140, Austin, TX 78702-4071 | 2019-12-12 |
| 1972149680 | Capsule Austin LLC | Pharmacy | 210 W 7th St Ste B, Austin, TX 78701-2903 | 2019-11-18 |
| 1427617570 | Shubha LLC | Pharmacy | 1139 W Braker Ln Ste 102, Austin, TX 78758-4113 | 2019-06-12 |
| 1467921668 | Clearview Specialty LLC | Pharmacy | 8101 Cameron Rd Ste 303, Austin, TX 78754-3818 | 2018-11-16 |
| 1639679319 | Randall Legacy Inc | Pharmacy | 8825 Bee Caves Rd Ste A, Austin, TX 78746-4720 | 2018-02-19 |
| 1356863898 | Raiine's Specialty Pharmacy LLC | Pharmacy | 1301 W 38th St Ste 135, Austin, TX 78705-1033 | 2017-07-15 |
| 1811364078 | Peoples Pharmacy | Pharmacy | 5505 W. Parmer Lane, Building 4, At Apple Wellness Center, Austin, TX 78727 | 2015-08-24 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.