Organization
VANS PHARMACY INC
Active
Other names
VANS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BUSSIS (PRESIDENT)
(269) 983-4802
Entity
Organization
Contact information
Practice address
807 NAPIER AVE, SAINT JOSEPH, MI 49085-2003
(269) 983-4802
(269) 983-7633
Mailing address
807 NAPIER AVE, SAINT JOSEPH, MI 49085-2003
(269) 983-4802
(269) 983-7633
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009293
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125058
PK
—
Enumeration date
06/09/2006
Last updated
07/09/2015
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