Organization
VITALAB PHARMACY INC
Active
Parent organization
ALERACARE HOLDINGS LLC
Other names
Vasco Infusion
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALERACARE HOLDINGS LLC
Authorized official
MR. PAUL VASILIAUSKAS PHARM D (SR.V.P. BUSINESS DEVELOPMENT)
(602) 971-6950
Entity
Organization
Contact information
Practice address
4045 E BELL RD STE 157, SUITE 157, PHOENIX, AZ 85032
(602) 346-0204
(877) 637-6691
Mailing address
4045 E BELL RD STE 157, SUITE 157, PHOENIX, AZ 85032-2240
(602) 346-0204
(877) 637-6691
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127832
—
AZ
05
—
302331
—
AZ
Enumeration date
09/18/2015
Last updated
04/28/2022
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