Provider Demographics
NPI:1063591733
Name:CAREPOINT PHARMACY INC
Entity type:Organization
Organization Name:CAREPOINT PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:PHRMD
Authorized Official - Phone:209-957-2295
Mailing Address - Street 1:73 W MARCH LN STE D
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5726
Mailing Address - Country:US
Mailing Address - Phone:209-957-2295
Mailing Address - Fax:209-957-2325
Practice Address - Street 1:73 W MARCH LN STE D
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5726
Practice Address - Country:US
Practice Address - Phone:209-957-2295
Practice Address - Fax:209-957-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY 471033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA471030Medicaid
2113498OtherPK
CAPHA431880Medicaid
CAPHA431880Medicaid