Healthcare Provider Details

I. General information

NPI: 1578029849
Provider Name (Legal Business Name): VP DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 COURT ST
NEWARK NJ
07102-2693
US

IV. Provider business mailing address

23 COURT ST
NEWARK NJ
07102-2693
US

V. Phone/Fax

Practice location:
  • Phone: 862-772-0442
  • Fax: 973-732-5504
Mailing address:
  • Phone: 862-772-0442
  • Fax: 973-732-5504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARISA DAVYDOVA
Title or Position: MANAGING MEMBER
Credential:
Phone: 862-772-0442