MEDICARE: VITAL CONNECTIONS, 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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1538237623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL CONNECTIONS, INC

Provider Business Mailing Address
First Line	:	206 N HERMAN ST
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27530-3810
Country	:	US
Telephone Number	:	919-736-4590
Fax Number	:

Provider Business Practice Location Address
First Line	:	206 N HERMAN ST
Second Line	:
City	:	GOLDSBORO
State	:	NC
Zip	:	27530-3810
Country	:	US
Telephone Number	:	919-736-4590
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CARLA REQUEL BRIGHT
Credential	:
Telephone Number	:	919-394-0466

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	08/22/2020

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