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General NPI Number Information
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NPI Number | 1487784674
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Entity Type | Organization
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Legal Business Name | SVP INC.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 720 N INDUSTRIAL BLVD
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City | EULESS
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State | TX
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Zip | 76039-7439
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Country | US
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Telephone | 817-283-5308
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Fax | 817-283-2308
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Provider Business Mailing Address
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Address Line | 720 N INDUSTRIAL BLVD
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City | EULESS
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State | TX
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Zip | 76039-7439
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Country | US
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Telephone | 817-283-5308
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Fax | 817-283-2308
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MS. JAYNE LAUGHBAUM
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Credential |
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Telephone | 817-283-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 16368
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License Number State | TX
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