Vine Hospitality, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

034320 Issued in NY

Legal business name

VINE HOSPITALITY, LLC

Doing business as

Equilibria

Practice address

320 Bedford Ave
1St Floor
Brooklyn, NY 11249-4368

Phone

(949) 705-8386

NPI assigned

Sep 21, 2016

Last updated

Sep 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vinnie Dam, PHARM.D.

Title

Supervising Pharmacist

Phone

(949) 705-8386

Specialties & licenses 1

Addresses

Other names 1

• Equilibria Doing business as

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1790233518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BEDFORD AVE",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112494368",
            "telephone_number": "949-705-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BEDFORD AVE",
            "address_2": "1ST FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112494368",
            "telephone_number": "949-705-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE HOSPITALITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "VINNIE",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "949-705-8386",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "034320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equilibria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shellyann Cindy Vincent
• William Ralph Vincent III, PHARMD
• Lydie A Vincentt, LPN
• Antoinette Vinci
• Desiree D Vindigni, M.S.
• Vinette W. Tummings, M.D.
• Michel Sacha Vington, MD
• Vinh Hoa Long Centre Pharmacy (Value Med Pharmacy)
• James Vining, LMSW
• Dmitry Vinnikov, RPA-C

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.