Provider Demographics
NPI:1982829610
Name:MED CENTER INC
Entity Type:Organization
Organization Name:MED CENTER INC
Other - Org Name:MED CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO/PIC
Authorized Official - Prefix:
Authorized Official - First Name:VIRAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:818-785-4944
Mailing Address - Street 1:14624 SHERMAN WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2287
Mailing Address - Country:US
Mailing Address - Phone:818-785-4944
Mailing Address - Fax:818-785-3918
Practice Address - Street 1:14624 SHERMAN WAY STE 104
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2287
Practice Address - Country:US
Practice Address - Phone:818-785-4944
Practice Address - Fax:818-785-3918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY59141OtherBOARD OF PHARMACY