Healthcare Provider Details

I. General information

NPI: 1548952575
Provider Name (Legal Business Name): VBRX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 GRASSDALE RD
CARTERSVILLE GA
30121-1975
US

IV. Provider business mailing address

630 TI PI LN
CHATSWORTH GA
30705-7786
US

V. Phone/Fax

Practice location:
  • Phone: 770-382-5757
  • Fax: 770-382-6757
Mailing address:
  • Phone: 770-382-5757
  • Fax: 770-382-6757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL P BRYANT
Title or Position: CFO
Credential:
Phone: 706-260-7998