Provider Demographics
NPI:1336124502
Name:VIPAL INC.
Entity Type:Organization
Organization Name:VIPAL INC.
Other - Org Name:CAMERON DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PRAFUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-729-6101
Mailing Address - Street 1:4 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1900
Mailing Address - Country:US
Mailing Address - Phone:973-729-6101
Mailing Address - Fax:973-729-4209
Practice Address - Street 1:4 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1900
Practice Address - Country:US
Practice Address - Phone:973-729-6101
Practice Address - Fax:973-729-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS00369800333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4365909Medicaid
NJ3127520OtherNCPDP NUMBER