VITAL HEALTH CARE LLC NPI 1396123733

NPI Information

NPI: 1396123733
Provider Name: VITAL HEALTH CARE LLC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
7707 W DEER VALLEY RD STE 115
PEORIA, AZ
ZIP 85382
Phone: (623) 218-1515
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VITAL HEALTH CARE LLC is an adult medicine family medicine in Peoria, AZ. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. VITAL HEALTH CARE LLC NPI is 1396123733. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7707 W DEER VALLEY RD STE 115
PEORIA, AZ
ZIP 85382-101
Phone: (623) 218-1515
Fax: (623) 399-9958

The provider's authorized official is Kevin Wray .
The authorized official title is Owner and has the following contact phone number (623) 218-1515.

The enumeration date for this NPI number is 5/18/2015 and was last updated on 5/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	2747	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2747	OTHER	ARIZONA	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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