MEDICARE: VITAL HEALTH SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1154193910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	67 GARFIELD AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2329
Country	:	US
Telephone Number	:	973-953-1672
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 GARFIELD AVE
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2329
Country	:	US
Telephone Number	:	973-953-1672
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	OLUWAGBENGA FILANI
Credential	:	RN
Telephone Number	:	917-435-1042

Provider Enumeration Date	:	10/25/2023
Last Update Date	:	10/25/2023

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