Healthcare Provider Details

I. General information

NPI: 1326339466
Provider Name (Legal Business Name): VIZION ONE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2011
Last Update Date: 04/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 BUSTLETON AVE STE 114
PHILADELPHIA PA
19152-1918
US

IV. Provider business mailing address

8400 BUSTLETON AVE STE 114
PHILADELPHIA PA
19152-1918
US

V. Phone/Fax

Practice location:
  • Phone: 215-665-5705
  • Fax: 240-751-4156
Mailing address:
  • Phone: 215-665-5705
  • Fax: 240-751-4156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number01111
License Number StatePA

VIII. Authorized Official

Name: ABDALLAH SULEIMAN KITWARA
Title or Position: CEO
Credential: MBA
Phone: 202-725-0772