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General NPI Number Information
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NPI Number | 1952604407
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Entity Type | Organization
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Legal Business Name | VITAL MEDICAL SUPPLIES & HEALTH SOLUTIONS,LLC
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 240 DEVEREAUX DR
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City | NATCHEZ
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State | MS
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Zip | 39120-3752
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Country | US
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Telephone | 601-442-1233
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Fax | 601-442-1232
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Provider Business Mailing Address
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Address Line | 240 DEVEREAUX DR
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City | NATCHEZ
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State | MS
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Zip | 39120-3752
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Country | US
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Telephone | 601-442-1233
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Fax | 601-442-1232
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Authorized Official
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Title or Position | OWNER/GENERAL MANAGER
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Name | VIOLA WELLS
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Credential |
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Telephone | 601-442-1233
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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 | 11377
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License Number State | MS
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