MEDICARE: VITAS HEALTHCARE CORPORATION MIDWEST

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1427114974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAS HEALTHCARE CORPORATION MIDWEST

Provider Business Mailing Address
First Line	:	3046 CORPORATE WAY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-6547
Country	:	US
Telephone Number	:	305-374-4143
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 EXECUTIVE DR STE 100
Second Line	:
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1366
Country	:	US
Telephone Number	:	618-622-9078
Fax Number	:	618-622-9230

Authorized Official
Title or Position	:	CEO
Name	:	NICK WESTFALL
Credential	:
Telephone Number	:	305-374-4143

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	04/30/2021

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