Provider Demographics
NPI:1255364386
Name:VINHS BROTHERS INC
Entity type:Organization
Organization Name:VINHS BROTHERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HIEU
Authorized Official - Middle Name:
Authorized Official - Last Name:VINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-282-9800
Mailing Address - Street 1:1365 1377 DORCHESTER AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122
Mailing Address - Country:US
Mailing Address - Phone:617-282-9800
Mailing Address - Fax:612-282-9814
Practice Address - Street 1:1365 1377 DORCHESTER AVE
Practice Address - Street 2:STE 1
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122
Practice Address - Country:US
Practice Address - Phone:617-282-9800
Practice Address - Fax:612-282-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
MADS34253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0407674Medicaid
2039556OtherPK
MA0407674Medicaid