MEDICARE: VPH PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5315025195	MI
2	1835G0303X	Geriatric Pharmacist	5315025195	MI
3	1835P1200X	Pharmacotherapy Pharmacist	5315025195	MI
4	1835P1300X	Psychiatric Pharmacist	5315025195	MI
5	183700000X	Pharmacy Technician	5315025195	MI
6	1835N1003X	Nutrition Support Pharmacist	5315025195	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336392539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VPH PHARMACY

Provider Business Mailing Address
First Line	:	5376 MILLER RD
Second Line	:
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1511
Country	:	US
Telephone Number	:	810-877-7170
Fax Number	:	810-733-1820

Provider Business Practice Location Address
First Line	:	5376 MILLER RD
Second Line	:
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1511
Country	:	US
Telephone Number	:	810-877-7170
Fax Number	:	810-733-1820

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	VINCENT HOWARD
Credential	:
Telephone Number	:	810-877-7170

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	10/31/2008

Similar Medicare Providers

1528019957 — VPH PHARMACY
Practice Location Address:

5376 MILLER RD
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48473-1511

Practice Phone: 810-877-7170
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1679853733 — VPH PHARMACY INC.
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Directions to “VPH PHARMACY ” Practice Location

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