1841011160 NPI number — DR. VANTONILE VIEN LAFFEY PHARMD

Table of content: DR. VANTONILE VIEN LAFFEY PHARMD (NPI 1841011160)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841011160 NPI number — DR. VANTONILE VIEN LAFFEY PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAFFEY
Provider First Name:
VANTONILE
Provider Middle Name:
VIEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUI
Provider Other First Name:
VANTONILE
Provider Other Middle Name:
VIEN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841011160
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5075 MOORELAND OAKS WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT HOLLY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28120-1039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-315-6103
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9820 CALLABRIDGE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28216-7669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-392-3131
Provider Business Practice Location Address Fax Number:
704-392-3484
Provider Enumeration Date:
10/19/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  24211 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com