Provider Demographics
NPI:1801285796
Name:VIBRANT CARE PHARMACY, INC.
Entity type:Organization
Organization Name:VIBRANT CARE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KALPESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-406-3089
Mailing Address - Street 1:7400 MACARTHUR BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2939
Mailing Address - Country:US
Mailing Address - Phone:510-406-3089
Mailing Address - Fax:
Practice Address - Street 1:7400 MACARTHUR BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2939
Practice Address - Country:US
Practice Address - Phone:510-406-3089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA51969OtherCALIFORNIA BOARD OF PHARMACY