Provider Demographics
NPI:1376069112
Name:VAISHNO-DEVI LLC
Entity Type:Organization
Organization Name:VAISHNO-DEVI LLC
Other - Org Name:SANFORD PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:PRIYAKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:919-274-8677
Mailing Address - Street 1:200 KINGS CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-5003
Mailing Address - Country:US
Mailing Address - Phone:919-267-9512
Mailing Address - Fax:919-480-2781
Practice Address - Street 1:1720 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5717
Practice Address - Country:US
Practice Address - Phone:919-274-8677
Practice Address - Fax:919-480-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC133283336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy