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General NPI Number Information
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NPI Number | 1134116809
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Entity Type | Organization
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Legal Business Name | VIALIFE CORPORATION
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Dates
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Enumeration Date | 09/28/2005
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 100 S ROWE ST
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City | PRYOR
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State | OK
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Zip | 74361-4606
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Country | US
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Telephone | 918-824-9600
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Fax | 918-824-4445
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Provider Business Mailing Address
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Address Line | 100 S ROWE ST
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City | PRYOR
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State | OK
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Zip | 74361-4606
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Country | US
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Telephone | 918-824-9600
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Fax | 918-824-4445
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Authorized Official
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Title or Position | CEO
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Name | ALESHA PENDERSON
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Credential |
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Telephone | 918-824-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7795
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License Number State | OK
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