Provider Demographics
NPI:1508970591
Name:V & R PHARMACY INC
Entity Type:Organization
Organization Name:V & R PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZNOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-664-8829
Mailing Address - Street 1:13300 HARGRAVE RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4373
Mailing Address - Country:US
Mailing Address - Phone:281-664-8829
Mailing Address - Fax:281-664-8830
Practice Address - Street 1:13300 HARGRAVE RD
Practice Address - Street 2:SUITE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4373
Practice Address - Country:US
Practice Address - Phone:281-664-8829
Practice Address - Fax:281-664-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2017-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX117393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4546620OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX149040Medicaid
TX149040Medicaid