MEDICARE: VITAL HEALTHCARE CAPITAL

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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1831038561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL HEALTHCARE CAPITAL

Provider Business Mailing Address
First Line	:	805 15TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-2207
Country	:	US
Telephone Number	:	702-727-6256
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 15TH ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-2207
Country	:	US
Telephone Number	:	702-727-6256
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	OMEGA MATTHEWS
Credential	:
Telephone Number	:	702-727-6256

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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Directions to “VITAL HEALTHCARE CAPITAL ” Practice Location

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