1386892933 NPI number — VITA HEALTHCARE INC

Table of content: (NPI 1386892933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386892933 NPI number — VITA HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VITA HEALTHCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VITA
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386892933
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00910-0310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-723-8482
Provider Business Mailing Address Fax Number:
209-205-9499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VITA HEALTHCARE INC
Provider Second Line Business Practice Location Address:
607A CALLE DEL PARQUE
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-723-8482
Provider Business Practice Location Address Fax Number:
209-205-9499
Provider Enumeration Date:
09/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SALGADO
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO-PRESIDENTE
Authorized Official Telephone Number:
787-723-8482

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 038484300 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com