Healthcare Provider Details

I. General information

NPI: 1326688490
Provider Name (Legal Business Name): VITAHEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N 2ND ST STE G
ST CHARLES IL
60174-1863
US

IV. Provider business mailing address

121 N 2ND ST STE G
ST CHARLES IL
60174-1863
US

V. Phone/Fax

Practice location:
  • Phone: 630-229-1471
  • Fax: 630-524-2959
Mailing address:
  • Phone: 630-229-1471
  • Fax: 630-524-2959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. NITIN KASHID
Title or Position: OWNER
Credential:
Phone: 630-229-1471