Healthcare Provider Details

I. General information

NPI: 1194644880
Provider Name (Legal Business Name): VITALAIR RESPIRATORY SOLUTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7849 TETON TRL
DOUGLASVILLE GA
30134-5758
US

IV. Provider business mailing address

7849 TETON TRL
DOUGLASVILLE GA
30134-5758
US

V. Phone/Fax

Practice location:
  • Phone: 678-708-6044
  • Fax:
Mailing address:
  • Phone: 678-708-6044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELA D DUKES
Title or Position: OWNER
Credential: RRT
Phone: 678-708-6044