Provider Demographics
NPI:1740011808
Name:VIGO HEALTH PHARMACY INC
Entity type:Organization
Organization Name:VIGO HEALTH PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:812-231-1040
Mailing Address - Street 1:1635 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-4044
Mailing Address - Country:US
Mailing Address - Phone:812-231-1040
Mailing Address - Fax:812-231-1044
Practice Address - Street 1:1635 N 3RD ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4044
Practice Address - Country:US
Practice Address - Phone:812-231-1040
Practice Address - Fax:812-231-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy