Healthcare Provider Details

I. General information

NPI: 1225173560
Provider Name (Legal Business Name): VINA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11207 N LAMAR BLVD STE A
AUSTIN TX
78753-3056
US

IV. Provider business mailing address

11207 N LAMAR BLVD STE A
AUSTIN TX
78753-3056
US

V. Phone/Fax

Practice location:
  • Phone: 512-977-8844
  • Fax: 512-977-8846
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number21937
License Number StateTX

VIII. Authorized Official

Name: DEBBIE HUYNH
Title or Position: PRESIDENT
Credential:
Phone: 512-977-8844