Organization
VIRGIN ISLANDS IV
Active
Other names
Virgin Islands IV, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY GORDON (PRESIDENT/COO)
(340) 513-4703
Entity
Organization
Contact information
Practice address
2024 EST. MT. WELCOME, SUITE #12, CHRISTIANSTED, VI 00820
(340) 719-8448
(340) 719-8484
Mailing address
2024 EST. MT. WELCOME, SUITE #12, CHRISTIANSTED, VI 00820
(340) 719-8448
(340) 719-8484
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
5009518
VI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5300493
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/12/2010
Last updated
11/29/2010
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