Healthcare Provider Details

I. General information

NPI: 1194874123
Provider Name (Legal Business Name): MEDICAL VILLAGE APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 VAUGHN RD STE K
BURLINGTON NC
27217-2919
US

IV. Provider business mailing address

1610 VAUGHN RD STE K
BURLINGTON NC
27217-2919
US

V. Phone/Fax

Practice location:
  • Phone: 336-228-1336
  • Fax: 336-227-0764
Mailing address:
  • Phone: 336-228-1336
  • Fax: 336-227-0764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number02144
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ABHIJITKUMAR CHAUHAN
Title or Position: OWNER
Credential:
Phone: 919-949-9801