MEDICARE: YOLA VITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146D00000X	Personal Emergency Response Attendant		PA

General Provider Information

NPI Number	:	1134818248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLA VITAL

Provider Business Mailing Address
First Line	:	2038 N CLEVELAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-1502
Country	:	US
Telephone Number	:	855-766-3494
Fax Number	:

Provider Business Practice Location Address
First Line	:	2038 N CLEVELAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-1502
Country	:	US
Telephone Number	:	855-766-3494
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2023
Last Update Date	:	05/04/2023

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Directions to “ YOLA VITAL ” Practice Location

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