Provider Demographics
NPI:1003330085
Name:VISU LLC
Entity Type:Organization
Organization Name:VISU LLC
Other - Org Name:29 TH ST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EZEIFE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-309-3866
Mailing Address - Street 1:2334 N 29TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-3409
Mailing Address - Country:US
Mailing Address - Phone:215-309-6866
Mailing Address - Fax:215-309-6865
Practice Address - Street 1:2334 N 29TH ST FL 1
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-3409
Practice Address - Country:US
Practice Address - Phone:215-309-6866
Practice Address - Fax:215-309-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy