Healthcare Provider Details

I. General information

NPI: 1568544948
Provider Name (Legal Business Name): VITAL CARE INFUSION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BI COUNTY BLVD SUITE 101
FARMINGDALE NY
11735-3943
US

IV. Provider business mailing address

100 E RIVERCENTER BLVD SUITE 1600
COVINGTON KY
41011-1555
US

V. Phone/Fax

Practice location:
  • Phone: 631-753-2244
  • Fax: 631-420-3789
Mailing address:
  • Phone: 859-392-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number023269
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number023269
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. REGIS ROBBINS
Title or Position: SECRETARY
Credential:
Phone: 859-392-3300