Healthcare Provider Details

I. General information

NPI: 1336392539
Provider Name (Legal Business Name): VPH PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2008
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5376 MILLER RD
SWARTZ CREEK MI
48473-1511
US

IV. Provider business mailing address

5376 MILLER RD
SWARTZ CREEK MI
48473-1511
US

V. Phone/Fax

Practice location:
  • Phone: 810-877-7170
  • Fax: 810-733-1820
Mailing address:
  • Phone: 810-877-7170
  • Fax: 810-733-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5315025195
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number5315025195
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5315025195
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number5315025195
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number5315025195
License Number StateMI
# 6
Primary TaxonomyY
Taxonomy Code1835N1003X
TaxonomyNutrition Support Pharmacist
License Number5315025195
License Number StateMI

VIII. Authorized Official

Name: VINCENT HOWARD
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 810-877-7170