Provider Demographics
NPI:1902990054
Name:VN PHARMACY
Entity Type:Organization
Organization Name:VN PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-717-8872
Mailing Address - Street 1:4782 JIMMY CARTER BLVD
Mailing Address - Street 2:STE 7
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4782 JIMMY CARTER BLVD
Practice Address - Street 2:STE 7
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3714
Practice Address - Country:US
Practice Address - Phone:770-717-0707
Practice Address - Fax:770-717-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
GAPHRE0086223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1149891OtherOTHER ID NUMBER
1149891OtherOTHER ID NUMBER