Healthcare Provider Details

I. General information

NPI: 1336639400
Provider Name (Legal Business Name): VITALANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N. CRAIG STREET SUITE 501
PITTSBURGH PA
15213
US

IV. Provider business mailing address

201 N. CRAIG STREET SUITE 501
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-209-7424
  • Fax: 412-360-7134
Mailing address:
  • Phone: 412-209-7424
  • Fax: 412-360-7134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPP482768
License Number StatePA

VIII. Authorized Official

Name: MR. BHAVI A. SHAH
Title or Position: EVP, CHIEF LEGAL & RISK OFFICER, GE
Credential:
Phone: 480-675-5653