Provider Demographics
NPI:1942884044
Name:VRAJ PHARMACY LLC
Entity Type:Organization
Organization Name:VRAJ PHARMACY LLC
Other - Org Name:ALL CARE PHARMACY - LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHOLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-449-0908
Mailing Address - Street 1:8790 CUYAMACA ST STE B
Mailing Address - Street 2:
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 STE B
Practice Address - Street 2:
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:2021-05-06
Last Update Date:2021-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942884044Medicaid
CA2139243OtherPK
CA51164OtherCA STATE BOARD OF PHARMACY