Healthcare Provider Details

I. General information

NPI: 1205841822
Provider Name (Legal Business Name): VANS INSTITUTIONAL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 MOUNT PELIA RD
MARTIN TN
38237-3812
US

IV. Provider business mailing address

154 MOUNT PELIA RD
MARTIN TN
38237-3812
US

V. Phone/Fax

Practice location:
  • Phone: 731-588-5138
  • Fax: 731-588-5137
Mailing address:
  • Phone: 731-588-5138
  • Fax: 731-588-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number3317
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberTN1947
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberOS02370
License Number StateAR

VIII. Authorized Official

Name: EMILY HASKINS
Title or Position: PHARMACIST IN CHARGE/ CO-OWNER
Credential: PHARM.D.
Phone: 731-588-5138