Provider Demographics
NPI:1124486030
Name:VIAN DRUG COMPANY LLC
Entity type:Organization
Organization Name:VIAN DRUG COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:918-773-8111
Mailing Address - Street 1:10 THORTON ST
Mailing Address - Street 2:
Mailing Address - City:VIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74962
Mailing Address - Country:US
Mailing Address - Phone:918-773-8111
Mailing Address - Fax:
Practice Address - Street 1:10 THORTON ST
Practice Address - Street 2:POB 465
Practice Address - City:VIAN
Practice Address - State:OK
Practice Address - Zip Code:74962
Practice Address - Country:US
Practice Address - Phone:918-773-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy