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General NPI Number Information
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NPI Number | 1437591278
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Entity Type | Organization
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Legal Business Name | VITAL PHARMACARE
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 1901 STAR BATT DR STE 200
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3712
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Country | US
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Telephone | 248-299-1701
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 STAR BATT DR STE 200
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3712
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Country | US
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Telephone | 248-299-1701
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | STEVE CAMISI
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Credential | PHARM.D.
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Telephone | 248-805-1981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 5301010041
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License Number State | MI
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