Healthcare Provider Details

I. General information

NPI: 1669301719
Provider Name (Legal Business Name): KALOS VITALITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SOUTH IRBY STREET, UNIT A PMB1095
FLORENCE SC
29505
US

IV. Provider business mailing address

2600 SOUTH IRBY STREET, UNIT A PMB1095
FLORENCE SC
29505
US

V. Phone/Fax

Practice location:
  • Phone: 843-616-2635
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISON DAVIS
Title or Position: CEO
Credential:
Phone: 843-616-3122