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Individual
MR. VINCENT L COSTA
Active
Individual
MR. VINCENT L COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP029979L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP029979L
PHARMACY LICENSE
PA
Enumeration date
10/04/2007
Last updated
10/04/2007
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