Individual
VADIM SHINKEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3824 MAIN ST, ANDERSON, IN 46013-4718
(860) 989-7520
Mailing address
3824 MAIN ST, ANDERSON, IN 46013-4718
(860) 989-7520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024805A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26024805A
PHARMACY
IN
Enumeration date
11/22/2020
Last updated
11/22/2020
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