Active NPI
VG's Pharmacy, Inc
Doing business as VG's Pharmacy #15
- Community/Retail Pharmacy
- Fenton, MI
National Provider Identifier
1285833806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301008666
- Legal business name
- VG'S PHARMACY, INC
- Doing business as
- VG's Pharmacy #15
- Practice address
- 1390 N Leroy St
Fenton, MI 48430-2762 - Phone
- (810) 629-6074
- NPI assigned
- Jul 13, 2007
- Last updated
- Nov 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bryon C Higgins, RPH
- Title
- Pharmacy Product Director
- Phone
- (810) 629-1383
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5301008666 | MI | Primary |
Addresses
Primary practice location
1390 N Leroy St
Fenton, MI 48430-2762
Mailing address
209 S Alloy Dr
Fenton, MI 48430-3401
Phone (810) 629-1383
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2370055 | Other | NABP | |
| 5195165 | Medicaid | MI |
Other names 1
- VG's Pharmacy #15
National Provider Directory
National Provider Directory- Tax ID family
- VG's Pharmacy 1
Other organizations with this tax ID 14
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1195430400000",
"number": "1285833806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 S ALLOY DR",
"city": "FENTON",
"state": "MI",
"postal_code": "484303401",
"telephone_number": "810-629-1383",
"fax_number": "810-750-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1390 N LEROY ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302762",
"telephone_number": "810-629-6074"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VG'S PHARMACY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-07-13",
"last_updated": "2007-11-19",
"status": "A",
"authorized_official_last_name": "HIGGINS",
"authorized_official_first_name": "BRYON",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "PHARMACY PRODUCT DIRECTOR",
"authorized_official_telephone_number": "810-629-1383",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MI",
"license": "5301008666",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "2370055",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5195165",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "VG's Pharmacy #15",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fenton, MI
- Tasha Linnea Vaara-Suydam, M.A., CCC-SLP
- Cheri Marie Vanlake
- John Paul Varani, PH.D.
- Diego Velasquez-Plata, DDS, MSD
- VG's Pharmacy Inc (VG's Pharmacy #1)
- Kellie Marie Vile, PHARMD
- Jacqui Lorraine Wade, RN., BSN
- Andrea Wagner, NP
- David Alan Wagner, D.D.S.
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2693)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.