Healthcare Provider Details

I. General information

NPI: 1972204469
Provider Name (Legal Business Name): VACHAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 QUINTILIO DR
BEAR DE
19701-6004
US

IV. Provider business mailing address

2500 W 4TH ST STE 1
WILMINGTON DE
19805-3352
US

V. Phone/Fax

Practice location:
  • Phone: 302-467-2747
  • Fax: 833-678-0316
Mailing address:
  • Phone: 302-660-8847
  • Fax: 302-502-3885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: AKSHAR PATEL
Title or Position: PRINCIPAL
Credential:
Phone: 678-977-9009