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General NPI Number Information
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NPI Number | 1467787770
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Entity Type | Organization
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Legal Business Name | VISCHNU INC
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 461 W HURON ST
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City | PONTIAC
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State | MI
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Zip | 48341-1601
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Country | US
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Telephone | 248-858-9630
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Fax | 248-858-9635
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Provider Business Mailing Address
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Address Line | 461 W HURON ST
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City | PONTIAC
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State | MI
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Zip | 48341-1601
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Country | US
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Telephone | 248-858-9630
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Fax | 248-858-9635
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Authorized Official
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Title or Position | PRESIDENT
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Name | PUSPHA PATEL
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Credential |
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Telephone | 248-858-9630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009214
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License Number State | MI
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