Healthcare Provider Details

I. General information

NPI: 1487738746
Provider Name (Legal Business Name): VITAL CARE OF CONNECTICUT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 MAIN ST
NORWALK CT
06851-4713
US

IV. Provider business mailing address

189 MAIN ST
NORWALK CT
06851-4713
US

V. Phone/Fax

Practice location:
  • Phone: 203-845-0616
  • Fax: 203-845-0736
Mailing address:
  • Phone: 203-845-0616
  • Fax: 203-845-0736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number2019
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2019
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPCY2019
License Number StateCT

VIII. Authorized Official

Name: MS. LEYLA SOKMEN
Title or Position: DIRECTOR
Credential:
Phone: 203-845-0616