Provider Demographics
NPI:1174078075
Name:VPRP, INC.
Entity type:Organization
Organization Name:VPRP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TOBIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-998-3030
Mailing Address - Street 1:17821 SANTIAGO BLVD
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:92861-4133
Mailing Address - Country:US
Mailing Address - Phone:714-998-3030
Mailing Address - Fax:714-998-6060
Practice Address - Street 1:17821 SANTIAGO BLVD
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:CA
Practice Address - Zip Code:92861-4133
Practice Address - Country:US
Practice Address - Phone:714-998-3030
Practice Address - Fax:714-998-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-20
Last Update Date:2016-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY533663336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy