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General NPI Number Information
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NPI Number | 1376069112
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Entity Type | Organization
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Legal Business Name | VAISHNO-DEVI LLC
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 1720 S HORNER BLVD
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City | SANFORD
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State | NC
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Zip | 27330-5717
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Country | US
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Telephone | 919-274-8677
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Fax | 919-480-2781
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Provider Business Mailing Address
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Address Line | 200 KINGS CASTLE DR
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City | APEX
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State | NC
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Zip | 27502-5003
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Country | US
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Telephone | 919-267-9512
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Fax | 919-480-2781
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Authorized Official
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Title or Position | PHARMACIST
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Name | PRIYAKANT PATEL
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Credential | RPH
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Telephone | 919-274-8677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 13328
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License Number State | NC
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