Provider Demographics
NPI:1336974344
Name:VASSAR PHARMACY LLC
Entity type:Organization
Organization Name:VASSAR PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUBER
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-882-9229
Mailing Address - Street 1:1110 W SAGINAW RD
Mailing Address - Street 2:
Mailing Address - City:VASSAR
Mailing Address - State:MI
Mailing Address - Zip Code:48768-9485
Mailing Address - Country:US
Mailing Address - Phone:989-882-9229
Mailing Address - Fax:989-882-9228
Practice Address - Street 1:1110 W SAGINAW RD
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:MI
Practice Address - Zip Code:48768-9485
Practice Address - Country:US
Practice Address - Phone:989-882-9229
Practice Address - Fax:989-882-9228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy