Provider Demographics
NPI:1093491433
Name:PHARM VINITA ACQUISITION LLC
Entity Type:Organization
Organization Name:PHARM VINITA ACQUISITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-256-2541
Mailing Address - Street 1:201 N SCRAPER ST
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-3209
Mailing Address - Country:US
Mailing Address - Phone:817-442-0484
Mailing Address - Fax:
Practice Address - Street 1:201 N SCRAPER ST
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-3209
Practice Address - Country:US
Practice Address - Phone:817-442-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHARM VINITA ACQUISITION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy