MEDICARE: VN CREATIVE CARE 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
2	333600000X	Pharmacy	27563	TX
3	3336C0003X	Community/Retail Pharmacy	27563	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2131104	OTHER		PK

General Provider Information

NPI Number	:	1669760492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VN CREATIVE CARE INC

Provider Business Mailing Address
First Line	:	111 S WILLIAM BARNETT AVE
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4541
Country	:	US
Telephone Number	:	281-593-3800
Fax Number	:	281-593-2928

Provider Business Practice Location Address
First Line	:	111 S WILLIAM BARNETT AVE
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-4541
Country	:	US
Telephone Number	:	281-593-3800
Fax Number	:	281-593-2928

Authorized Official
Title or Position	:	PHARMACISTS
Name	:	NIPUL PATEL
Credential	:
Telephone Number	:	281-593-3800

Provider Enumeration Date	:	07/13/2011
Last Update Date	:	08/12/2022

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