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General NPI Number Information
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NPI Number | 1568823607
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Entity Type | Organization
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Legal Business Name | VECTRA HEALTH
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 4 LONG COVE CT
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City | GREENSBORO
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State | NC
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Zip | 27407-5843
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Country | US
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Telephone | 913-735-7578
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Fax |
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Provider Business Mailing Address
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Address Line | 6420 RAINS DAVIS RD
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City | KERNERSVILLE
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State | NC
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Zip | 27284-0127
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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 | DIRECTOR
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Name | DR. J DOUGLAS SMITH
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Credential | PHARMD.
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Telephone | 913-735-7578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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