Provider Demographics
NPI:1043960370
Name:VVSB PHARMACY INC
Entity Type:Organization
Organization Name:VVSB PHARMACY INC
Other - Org Name:ROBERT JACOBSON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:PHAMD
Authorized Official - Phone:917-412-6622
Mailing Address - Street 1:231 ASHBURTON AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3227
Mailing Address - Country:US
Mailing Address - Phone:914-965-3049
Mailing Address - Fax:
Practice Address - Street 1:231 ASHBURTON AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3227
Practice Address - Country:US
Practice Address - Phone:914-965-3049
Practice Address - Fax:914-965-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy