Individual provider Active NPI

Vittelian Forbes, RPH

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1124463138
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S019246 Issued in AZ
Practice address
1701 E Thomas Rd Ste 105
Phoenix, AZ 85016-7672
Phone
(602) 237-6677
NPI assigned
May 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S019246 AZ Primary

Addresses

Primary practice location

1701 E Thomas Rd Ste 105
Phoenix, AZ 85016-7672

Mailing address

7020 E Moreland St
Scottsdale, AZ 85257-3318
Phone (480) 329-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S019246AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mesa Neighborhood Pharmacy LLC CurrentSince Jun 18, 2023 Accepting new patients
Mesa Neighborhood Pharmacy LLC CurrentSince Jun 18, 2023 Accepting new patients
Civara Behavioral Health LLC PastSince Oct 4, 2020 Accepting new patients

Locations

1701 E Thomas Rd
Ste 105
Phoenix, AZ 85016
Phone (480) 329-9585

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1124463138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 E MORELAND ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573318",
            "telephone_number": "480-329-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E THOMAS RD STE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167672",
            "telephone_number": "602-237-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "VITTELIAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-03",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.