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General NPI Number Information
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NPI Number | 1881680718
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Entity Type | Organization
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Legal Business Name | V V L S PHARMACY LLC
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 3800 HORIZON BLVD STE 103
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City | TREVOSE
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State | PA
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Zip | 19053-4968
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Country | US
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Telephone | 215-494-9403
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Fax | 215-357-2129
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Provider Business Mailing Address
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Address Line | 3800 HORIZON BLVD SUITE 103
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City | TREVOSE
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State | PA
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Zip | 19053-4968
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Country | US
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Telephone | 215-494-9403
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Fax | 215-357-2129
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Authorized Official
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Title or Position | CEO
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Name | GREG GANSE
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Credential |
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Telephone | 717-394-5671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | A9-0001619
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP410111L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 033631
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28RO00089200
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0214001747
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License Number State | VA
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Taxonomy #6
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P06955
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License Number State | MD
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Taxonomy #7
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PH29216
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | NRX0000677
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License Number State | DC
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