Healthcare Provider Details

I. General information

NPI: 1598589335
Provider Name (Legal Business Name): VIGILANCE HEALTH ASSESSMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE B
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE B
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 419-340-8662
  • Fax:
Mailing address:
  • Phone: 419-340-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: JOHANNA CALGIE
Title or Position: MEMBER
Credential:
Phone: 419-340-8662