Provider Demographics
NPI:1639697956
Name:LV HEALTHCARE LLC
Entity Type:Organization
Organization Name:LV HEALTHCARE LLC
Other - Org Name:LV HEALTH & WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:618-589-9889
Mailing Address - Street 1:1219 THOUVENOT LN STE 111
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:IL
Mailing Address - Zip Code:62269
Mailing Address - Country:US
Mailing Address - Phone:618-589-9889
Mailing Address - Fax:618-589-9889
Practice Address - Street 1:1219 THOUVENOT LN STE 111
Practice Address - Street 2:
Practice Address - City:SHILOH
Practice Address - State:IL
Practice Address - Zip Code:62269-7392
Practice Address - Country:US
Practice Address - Phone:618-589-9889
Practice Address - Fax:618-589-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy