MEDICARE: VITALEDGE WELLNESS LLC

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1174471205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITALEDGE WELLNESS LLC

Provider Business Mailing Address
First Line	:	100 W RIDGE PIKE STE 201
Second Line	:
City	:	LIMERICK
State	:	PA
Zip	:	19468-1714
Country	:	US
Telephone Number	:	855-678-3663
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W RIDGE PIKE STE 201
Second Line	:
City	:	LIMERICK
State	:	PA
Zip	:	19468-1714
Country	:	US
Telephone Number	:	855-678-3663
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RYAN BROWN
Credential	:	CFNC, CPPC
Telephone Number	:	215-852-5555

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “VITALEDGE WELLNESS LLC ” Practice Location

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