Healthcare Provider Details

I. General information

NPI: 1528666443
Provider Name (Legal Business Name): MVP PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 WHEELER RD
HAUPPAUGE NY
11788-2900
US

IV. Provider business mailing address

930 WHEELER RD
HAUPPAUGE NY
11788-2900
US

V. Phone/Fax

Practice location:
  • Phone: 631-724-7096
  • Fax: 631-724-7098
Mailing address:
  • Phone: 631-724-7096
  • Fax: 631-724-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SPECCHIO
Title or Position: PRESIDENT
Credential:
Phone: 631-252-6009