Healthcare Provider Details

I. General information

NPI: 1457208183
Provider Name (Legal Business Name): VITALHEALTH NURSING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 CHESAPEAKE WAY
COLUMBUS GA
31907-7340
US

IV. Provider business mailing address

935 CHESAPEAKE WAY
COLUMBUS GA
31907-7340
US

V. Phone/Fax

Practice location:
  • Phone: 706-615-5583
  • Fax:
Mailing address:
  • Phone: 706-615-5583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEVIN ALEXANDER PORTER
Title or Position: OWNER/MANAGER/ADMINISTRATOR
Credential: RN
Phone: 706-615-5583