Provider Demographics
NPI:1407216567
Name:VITA CARE, INC.
Entity Type:Organization
Organization Name:VITA CARE, INC.
Other - Org Name:MED-CARE RX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PIC
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-650-6799
Mailing Address - Street 1:14550 HAYNES ST
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-1613
Mailing Address - Country:US
Mailing Address - Phone:818-650-6799
Mailing Address - Fax:
Practice Address - Street 1:14550 HAYNES ST
Practice Address - Street 2:SUITE 200A
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-1613
Practice Address - Country:US
Practice Address - Phone:818-650-6799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy