Healthcare Provider Details

I. General information

NPI: 1336832021
Provider Name (Legal Business Name): VIHAAN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6451 ZEBULON RD STE B
MACON GA
31220-7602
US

IV. Provider business mailing address

6451 ZEBULON RD STE B
MACON GA
31220-7602
US

V. Phone/Fax

Practice location:
  • Phone: 478-254-3255
  • Fax:
Mailing address:
  • Phone: 478-254-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUMIL PATEL
Title or Position: PHARMACIST
Credential:
Phone: 912-282-1657