Healthcare Provider Details

I. General information

NPI: 1679853733
Provider Name (Legal Business Name): VPH PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
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 TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5301008325
License Number StateMI

VIII. Authorized Official

Name: MR. VINCENT PAUL HOWARD
Title or Position: CEO
Credential: PHARM D.
Phone: 810-877-7170