Provider Demographics
NPI:1912710310
Name:VICI HEALTH SCIENCES
Entity type:Organization
Organization Name:VICI HEALTH SCIENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCESCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MINALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-445-6813
Mailing Address - Street 1:6679 SANTA BARBARA RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5846
Mailing Address - Country:US
Mailing Address - Phone:410-403-3939
Mailing Address - Fax:443-445-6813
Practice Address - Street 1:6679 SANTA BARBARA RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-5846
Practice Address - Country:US
Practice Address - Phone:410-403-3939
Practice Address - Fax:443-445-6813
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VICI HEALTH SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy