Provider Demographics
NPI:1881727634
Name:VIERAN CORP
Entity type:Organization
Organization Name:VIERAN CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PHUONG
Authorized Official - Middle Name:DUNG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:760-745-6672
Mailing Address - Street 1:307 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3015
Mailing Address - Country:US
Mailing Address - Phone:760-745-6672
Mailing Address - Fax:760-745-2420
Practice Address - Street 1:307 N ASH ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3015
Practice Address - Country:US
Practice Address - Phone:760-745-6672
Practice Address - Fax:760-745-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty