MEDICARE: V.P.P. LTC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy	PHY47468	CA

General Provider Information

NPI Number	:	1144264987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V.P.P. LTC INC

Provider Business Mailing Address
First Line	:	3039 W VALLEY BLVD
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91803-1822
Country	:	US
Telephone Number	:	626-281-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	3039 W VALLEY BLVD
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91803-1822
Country	:	US
Telephone Number	:	626-281-3799
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LAWRENCE WONG
Credential	:	PHARM. D
Telephone Number	:	818-952-2108

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	08/22/2020

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