Healthcare Provider Details

I. General information

NPI: 1053737114
Provider Name (Legal Business Name): VSAB PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2014
Last Update Date: 03/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 PENINSULA BLVD
HEWLETT NY
11557-1226
US

IV. Provider business mailing address

1336 PENINSULA BLVD
HEWLETT NY
11557-1226
US

V. Phone/Fax

Practice location:
  • Phone: 516-791-6700
  • Fax:
Mailing address:
  • Phone: 516-791-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. KARTHIK DHAMA
Title or Position: PRESIDENT
Credential:
Phone: 516-581-5025