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NPI Code Detail

MEDICARE: VITALSTAT, INC.

MEDICARE: VITALSTAT, INC.
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
13336L0003XLong Term Care Pharmacy111152AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1510-56579OTHERALBCBS, NON-PAR

General Provider Information

NPI Number : 1518978691
Entity Type Code : Organization
Provider Name (Legal Business Name) : VITALSTAT, INC.
Provider Business Mailing Address
First Line : PO BOX 5047
Second Line :
City : MERIDIAN
State : MS
Zip : 39302-5047
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 103 SAND MOUNTAIN DR NE
Second Line :
City : ALBERTVILLE
State : AL
Zip : 35950-1709
Country : US
Telephone Number : 256-878-2111
Fax Number :
Authorized Official
Title or Position : OWNER
Name : T BISHOP
Credential :
Telephone Number : 256-878-2111
Provider Enumeration Date : 08/11/2006
Last Update Date : 08/22/2020

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