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General NPI Number Information
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NPI Number | 1083036651
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Entity Type | Organization
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Legal Business Name | FOREFRONT-RUSH MEDICAL SERVICE PA
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 1901 MEDI PARK DR STE 2058
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City | AMARILLO
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State | TX
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Zip | 79106-2109
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Country | US
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Telephone | 254-624-3999
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 MAIN ST STE 5850
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City | DALLAS
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State | TX
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Zip | 75201-7317
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Country | US
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Telephone | 972-449-0540
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Fax | 972-449-0542
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Authorized Official
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Title or Position | DIRECTOR PAYER OPERATIONS
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Name | SARA VITULLO
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Credential |
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Telephone | 469-895-9275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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