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General NPI Number Information
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NPI Number | 1891838272
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Entity Type | Organization
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Legal Business Name | VIP PHARMACY INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 13193 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-4179
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Country | US
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Telephone | 909-573-0123
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Fax | 909-573-0111
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Provider Business Mailing Address
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Address Line | 13193 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-4179
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Country | US
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Telephone | 909-573-0123
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Fax | 909-573-0111
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Authorized Official
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Title or Position | PIC
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Name | ERIC SIRICH
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Credential |
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Telephone | 909-573-0123
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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 | PHY48390
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License Number State | CA
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