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General NPI Number Information
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NPI Number | 1073712337
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Entity Type | Organization
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Legal Business Name | DOCTORS VITAL CARE AND SCREENING, PLLC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 150 N STEELE ST
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City | SANFORD
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State | NC
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Zip | 27330-3918
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Country | US
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Telephone | 919-776-7255
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Fax | 919-776-5011
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Provider Business Mailing Address
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Address Line | 150 N STEELE ST
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City | SANFORD
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State | NC
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Zip | 27330-3918
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Country | US
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Telephone | 919-776-7255
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Fax | 919-776-5011
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. POONAM AJIMANI
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Credential |
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Telephone | 919-740-2864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 102462
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License Number State | NC
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