MEDICARE: VANMOL LLC

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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1932525	OTHER	LA	NCPD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952335937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANMOL LLC

Provider Business Mailing Address
First Line	:	9374 HIGHWAY 165 SOUTH
Second Line	:
City	:	WOODWORTH
State	:	LA
Zip	:	71485-9786
Country	:	US
Telephone Number	:	318-443-7073
Fax Number	:	318-443-7052

Provider Business Practice Location Address
First Line	:	9374 HWY 165
Second Line	:
City	:	WOODWORTH
State	:	LA
Zip	:	71485
Country	:	US
Telephone Number	:	318-443-7073
Fax Number	:	318-443-7052

Authorized Official
Title or Position	:	OWNER
Name	:	PETER SAAD
Credential	:
Telephone Number	:	318-443-7073

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	06/07/2023

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Directions to “VANMOL LLC ” Practice Location

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