Healthcare Provider Details

I. General information

NPI: 1528019957
Provider Name (Legal Business Name): VPH PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/11/2016
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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301009617
License Number StateMI

VIII. Authorized Official

Name: NANDAN PATEL
Title or Position: OWNER
Credential:
Phone: 734-673-7829