Healthcare Provider Details

I. General information

NPI: 1700794278
Provider Name (Legal Business Name): VITAL STRENGTH INTERNAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 DEVINE ST
COLUMBIA SC
29205-2403
US

IV. Provider business mailing address

2301 DEVINE ST
COLUMBIA SC
29205-2403
US

V. Phone/Fax

Practice location:
  • Phone: 803-622-6480
  • Fax: 803-845-3261
Mailing address:
  • Phone: 803-622-6480
  • Fax: 803-845-3261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LORI L COOK
Title or Position: OWNER
Credential: MD
Phone: 803-622-6480