Provider Demographics
NPI:1952317273
Name:VLS CAPITOL DRUGS INC
Entity Type:Organization
Organization Name:VLS CAPITOL DRUGS INC
Other - Org Name:CAPITOL DRUGS - WEST HOLLYWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-289-5277
Mailing Address - Street 1:8702 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4508
Mailing Address - Country:US
Mailing Address - Phone:310-289-5277
Mailing Address - Fax:
Practice Address - Street 1:8578 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4119
Practice Address - Country:US
Practice Address - Phone:310-289-0773
Practice Address - Fax:310-289-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY538243336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2157792OtherPK
0519528OtherNCPDP PROVIDER IDENTIFICATION NUMBER
CAPHA396920Medicaid