Vans Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009293 Issued in MI

Legal business name

VANS PHARMACY INC

Doing business as

VANS PHARMACY

Practice address

807 Napier Ave
Saint Joseph, MI 49085-2003

Phone

(269) 983-4802

Fax

(269) 983-7633

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

James Bussis

Title

President

Phone

(269) 983-4802

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VANS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Jay Vanantwerp, RPH

  • Pharmacist
  • Saint Joseph, MI
  • NPI 1588993042
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1932140365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852003",
            "telephone_number": "269-983-4802",
            "fax_number": "269-983-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852003",
            "telephone_number": "269-983-4802",
            "fax_number": "269-983-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "BUSSIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-983-4802"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125058",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VANS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannin B Vanderark
• Jason Vanderlugt, M.D.
• Amber Ann Vanderwal
• Kavitha Vangapally, PT
• Courtney Marie Vanophem, DO
• Victoria Vasko, RD
• Allison Cristine Vaughan, DO
• Andrew Joseph Vaughan, D.O.
• Yojana Veeramasuneni, PSYD
• Geertje Willemijn Veldhuijzen, PHARM.D

• Community/Retail Pharmacy in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.