MEDICARE: VPH PHARMACY INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	5301008325	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

General Provider Information

NPI Number	:	1679853733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VPH PHARMACY INC.

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	:	CEO
Name	:	MR. VINCENT PAUL HOWARD
Credential	:	PHARM D.
Telephone Number	:	810-877-7170

Provider Enumeration Date	:	08/22/2011
Last Update Date	:	08/22/2011

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