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General NPI Number Information
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NPI Number | 1861797391
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Entity Type | Organization
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Legal Business Name | VITALWEAR, INC
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 384 OYSTER POINT BLVD SUITE 16
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-1935
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Country | US
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Telephone | 650-553-4100
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Fax | 650-553-4104
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Provider Business Mailing Address
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Address Line | 384 OYSTER POINT BLVD SUITE 16
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-1935
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Country | US
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Telephone | 650-553-4100
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Fax | 650-553-4104
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | HOWARD EDELMAN
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Credential |
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Telephone | 650-553-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 63598
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License Number State | CA
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