MEDICARE: VITAL HEAVEN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1578440251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL HEAVEN LLC

Provider Business Mailing Address
First Line	:	15270 VOSS RD APT 530
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-4776
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15270 VOSS RD APT 530
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-4776
Country	:	US
Telephone Number	:	346-535-2815
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MUHAMMAD FARRUKH
Credential	:
Telephone Number	:	346-535-2815

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	08/27/2025

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Directions to “VITAL HEAVEN LLC ” Practice Location

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