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General NPI Number Information
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NPI Number | 1437132024
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Entity Type | Organization
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Legal Business Name | VITAL LINE CORPORATION
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 221 E. WISCONSIN RD
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City | EDINBURG
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State | TX
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Zip | 78540
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Country | US
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Telephone | 956-383-5527
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Fax | 956-383-4592
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Provider Business Mailing Address
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Address Line | 221 E. WISCONSIN RD P.O. BOX 3666
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City | EDINBURG
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State | TX
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Zip | 78540
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Country | US
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Telephone | 956-383-5527
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Fax | 956-383-4592
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. IVAN MELENDEZ
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Credential | M.D.
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Telephone | 956-213-5070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | TX
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