Provider Demographics
NPI:1447591110
Name:VRAJ PHARMACY LLC
Entity Type:Organization
Organization Name:VRAJ PHARMACY LLC
Other - Org Name:ALL CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHOLIA
Authorized Official - Suffix:
Authorized Official - Credentials:BPHARM RPH
Authorized Official - Phone:619-449-0908
Mailing Address - Street 1:8790 CUYAMACA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4295
Mailing Address - Country:US
Mailing Address - Phone:619-449-0908
Mailing Address - Fax:619-449-0936
Practice Address - Street 1:8790 CUYAMACA ST
Practice Address - Street 2:SUITE B
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4295
Practice Address - Country:US
Practice Address - Phone:619-449-0908
Practice Address - Fax:619-449-0936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X, 3336S0011X
CA511643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1447591110Medicaid
2139243OtherPK
2139243OtherPK
CA1447591110Medicaid