Active NPI
V V L S Pharmacy LLC
- Specialty Pharmacy
- Trevose, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialty Pharmacy
- License
- PH29216
- Legal business name
- V V L S PHARMACY LLC
- Doing business as
- Altruix
- Practice address
- 3800 Horizon Blvd
Ste 103
Trevose, PA 19053-4968 - Phone
- (215) 494-9403
- Fax
- (215) 357-2129
- NPI assigned
- Sep 26, 2005
- 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
- Randy Hyun
- Title
- Ceo
- Phone
- (667) 408-7767
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | A9-0001619 | DE | |
| Community/Retail Pharmacy | 3336C0003X | PP410111L | PA | |
| Community/Retail Pharmacy | 3336C0003X | 033631 | NY | |
| Community/Retail Pharmacy | 3336C0003X | 28RO00089200 | NJ | |
| Community/Retail Pharmacy | 3336C0003X | NRX0000677 | DC | |
| Community/Retail Pharmacy | 3336C0003X | 0214001747 | VA | |
| Community/Retail Pharmacy | 3336C0003X | P06955 | MD | |
| Specialty Pharmacy | 3336S0011X | PH29216 | FL | Primary |
Addresses
Primary practice location
3800 Horizon Blvd
Ste 103
Trevose, PA 19053-4968
Mailing address
40 Wight Ave Ste 100
Cockeysville, MD 21030-2148
Phone (667) 408-7767
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007473110001 | Medicaid | PA | |
| 2125309 | Other | PK |
Other names 1
- Altruix
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101217000858 | PA | DME Supplier - Pharmacy | 2264620137 | Practice locations: Trevose, PA |
| O20241120003448 | PA | Part B Supplier - Pharmacy | 2264620137 | Practice locations: Trevose, PA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| V V L S Pharmacy Inc | Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs | Accepts assignment |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
3800 Horizon Blvd
Ste 103
Trevose, PA 19053
Phone (215) 494-9403
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Trevose, PA
- NPI 1003108796
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784851200000",
"number": "1881680718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 WIGHT AVE STE 100",
"city": "COCKEYSVILLE",
"state": "MD",
"postal_code": "210302148",
"telephone_number": "667-408-7767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 HORIZON BLVD",
"address_2": "STE 103",
"city": "TREVOSE",
"state": "PA",
"postal_code": "190534968",
"telephone_number": "215-494-9403",
"fax_number": "215-357-2129"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "V V L S PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-26",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A",
"authorized_official_last_name": "HYUN",
"authorized_official_first_name": "RANDY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "667-408-7767"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "DE",
"license": "A9-0001619",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "PA",
"license": "PP410111L",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NY",
"license": "033631",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NJ",
"license": "28RO00089200",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "DC",
"license": "NRX0000677",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "VA",
"license": "0214001747",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MD",
"license": "P06955",
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "FL",
"license": "PH29216",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007473110001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2125309",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Altruix",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Trevose, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.