| Vital Life Pharmacy | |
|
418 N Loop 1604 W Ste 104 San Antonio TX 78232-1456 | |
| (210) 802-0553 | |
| Not Available |
| Full Name | Vital Life Pharmacy |
|---|---|
| Speciality | Pharmacy |
| Location | 418 N Loop 1604 W Ste 104, San Antonio, Texas |
| Authorized Official Name and Position | Raj Milan Chhadua (OWNER/MANAGING PARTNER) |
| Authorized Official Contact | 2144222598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Life Pharmacy Po Box 2735 Frisco TX 75034-0051 Ph: (469) 294-2001 | Vital Life Pharmacy 418 N Loop 1604 W Ste 104 San Antonio TX 78232-1456 Ph: (210) 802-0553 |
| NPI Number | 1669487286 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/14/2023 |
| Medicare PECOS PAC ID | 5799028726 |
|---|---|
| Medicare Enrollment ID | O20190515001254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669487286 | NPI | - | NPPES |
| 4540399 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 145643 | Medicaid | TX | |
| 32470 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
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