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General NPI Number Information
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NPI Number | 1720380140
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Entity Type | Organization
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Legal Business Name | VJK CORP
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 119 E PATERSON ST
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City | KALAMAZOO
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State | MI
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Zip | 49007-2530
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Country | US
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Telephone | 269-226-9000
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Fax | 269-226-9033
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Provider Business Mailing Address
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Address Line | 119 E PATERSON ST
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City | KALAMAZOO
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State | MI
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Zip | 49007-2530
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Country | US
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Telephone | 269-226-9000
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Fax | 269-226-9033
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIJAY RAVAL
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Credential |
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Telephone | 269-226-9000
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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 | 5301009448
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License Number State | MI
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