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General NPI Number Information
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NPI Number | 1558984922
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Entity Type | Organization
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Legal Business Name | VITORA VENTURES INC
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 138 W. CENTERVILLE RD # 100
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City | GARLAND
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State | TX
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Zip | 75041
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Country | US
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Telephone | 972-271-0001
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Fax | 972-271-0005
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Provider Business Mailing Address
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Address Line | PO BOX 472688
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City | GARLAND
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State | TX
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Zip | 75047-2688
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDELAZIZ KETANI
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Credential |
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Telephone | 214-777-2004
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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 |
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License Number State |
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