Provider Demographics
NPI:1023298122
Name:VAC PHARMACY INC
Entity type:Organization
Organization Name:VAC PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-495-4331
Mailing Address - Street 1:9888 BISSONNET ST STE 405
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8299
Mailing Address - Country:US
Mailing Address - Phone:832-269-5944
Mailing Address - Fax:832-548-1679
Practice Address - Street 1:9888 BISSONNET ST STE 405
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8299
Practice Address - Country:US
Practice Address - Phone:832-269-5944
Practice Address - Fax:832-548-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2123350OtherPK