=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891668075
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VITAHEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2025
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1834 OREGON PIKE STE 2
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17601-6463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-208-5686
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 LARK LN
-----------------------------------------------------
City | LANCASTER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17603-9529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-929-2899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. WILLIS GODIN
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 609-929-2899
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QI0500X
-----------------------------------------------------
Taxonomy Name | Infusion Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------