Organization
VILLAGE PHARMACY INC
Active
Other names
Village Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRANT SKANSON (OWNER PHARMACIST)
(775) 831-1133
Entity
Organization
Contact information
Practice address
898 TANAGER ST, INCLINE VILLAGE, NV 89451-9475
(775) 831-1133
(775) 831-2228
Mailing address
898 TANAGER ST, INCLINE VILLAGE, NV 89451-9475
(775) 831-1133
(775) 831-2228
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH01587
NV
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114969649
—
NV
01
—
2056528
PK
—
Enumeration date
06/11/2006
Last updated
06/07/2023
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