Provider Demographics
NPI:1033414339
Name:V & T PHARMACY INC
Entity Type:Organization
Organization Name:V & T PHARMACY INC
Other - Org Name:V & T PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOAIVY
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-4732
Mailing Address - Street 1:4040 W WATERS AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-8155
Mailing Address - Country:US
Mailing Address - Phone:813-443-4732
Mailing Address - Fax:813-443-4789
Practice Address - Street 1:4040 W WATERS AVE STE 105
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-8155
Practice Address - Country:US
Practice Address - Phone:813-443-4732
Practice Address - Fax:813-443-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH251743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5703738OtherNCPDP PROVIDER IDENTIFICATION NUMBER