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General NPI Number Information
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NPI Number | 1811397508
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Entity Type | Organization
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Legal Business Name | NELCO VET LLC
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 154 BROOK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-7251
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Country | US
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Telephone | 631-242-3662
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Fax | 631-242-3290
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Provider Business Mailing Address
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Address Line | 154 BROOK AVE
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City | DEER PARK
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State | NY
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Zip | 11729-7251
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Country | US
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Telephone | 631-242-3662
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Fax | 631-242-3290
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Authorized Official
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Title or Position | OWNER
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Name | ALBERTO LOPEZ
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Credential |
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Telephone | 631-242-3662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order 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 | 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 #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 032267
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License Number State | NY
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