NPIMap

Individual provider Active NPI

Victoria Nicole Vince, PHARMD

  • Pharmacist
  • Mandeville, LA
National Provider Identifier
1194126474
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.020722 Issued in LA
Practice address
4330 Highway 22
Mandeville, LA 70471-3317
Phone
(985) 674-2551
Fax
(504) 910-8914
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.020722 LA Primary

Addresses

Primary practice location

4330 Highway 22
Mandeville, LA 70471-3317

Mailing address

329 Independence Dr
Mandeville, LA 70471-8527
Phone (504) 858-5029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PST.020722LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1194126474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 INDEPENDENCE DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704718527",
            "telephone_number": "504-858-5029",
            "fax_number": "504-910-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 HIGHWAY 22",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713317",
            "telephone_number": "985-674-2551",
            "fax_number": "504-910-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCE",
        "first_name": "VICTORIA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.020722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.