Vitacare Pharmacy Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

44770 Issued in CA

Legal business name

VITACARE PHARMACY INC.

Practice address

2447 Telegraph Ave
Oakland, CA 94612-2404

Phone

(510) 832-7500

Fax

(510) 832-2009

NPI assigned

Nov 23, 2017

Organization subpart

No

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

Authorized official

Name

Yonathan Seyoum, RPH

Title

Manager/Owner

Phone

(510) 832-7500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• YONATHAN SEYOUM Former legal business name

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

{
    "created_epoch": "1511395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1902310246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122404",
            "telephone_number": "510-832-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 TELEGRAPH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946122404",
            "telephone_number": "510-832-7500",
            "fax_number": "510-832-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITACARE PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-23",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "SEYOUM",
        "authorized_official_first_name": "YONATHAN",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "510-832-7500",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "44770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY STATE LICENSE NUMBER",
            "identifier": "51535",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YONATHAN SEYOUM",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Annapurna Vissa, MSN RN
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• Sheila Viswanathan, R.D.
• Vitacare Pharmacy Inc. (Vitacare Pharmacy)
• Vital Link Medical Alert Systems
• Vital Testing Labs LLC
• Christopher R Vitale
• Sean Vitali
• Jan A Vitek, PH.D.

• Pharmacy in Oakland, CA
• Providers in Oakland, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.