Bluegrass LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP481659 Issued in PA

Legal business name

BLUEGRASS LLC

Practice address

202 Holland Rd Ste 230
Holland, PA 18966-1703

Phone

(215) 676-7650

Fax

(215) 676-8086

NPI assigned

Dec 18, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tanya Minaeva

Title

Owner

Phone

(215) 676-7650

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BLUEGRASS PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1891858411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 HOLLAND RD STE 230",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661703",
            "telephone_number": "215-676-7650",
            "fax_number": "215-676-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 HOLLAND RD STE 230",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189661703",
            "telephone_number": "215-676-7650",
            "fax_number": "215-676-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "MINAEVA",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-676-7650"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP481659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10186675001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2081747",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLUEGRASS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BLUEGRASS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Andrew Becker, PHARMD
• Irene R Belder, PHARMD
• Melanie Shayna Bellissima
• Naresh C Bhavsar, D.M.D.
• Yvonne M Blackwell
• Caitlin Brown, MS, CCC-SLP/L
• Heidi Candace Bryk, PTA
• Morgan Kaylee Caione
• Caring Hands Loving Hearts Inc.
• Thomas Arthur Caruso, DDS

• Community/Retail Pharmacy in Holland, PA
• Providers in Holland, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.