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Contact Information

VITAL WELLNESS HEALTHCARE, INC.
2621 MONTEGA DR STE E
SPRINGFIELD, IL62704
 Phone: 217-717-1909
 Fax: 217-717-1957
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for VITAL WELLNESS HEALTHCARE, INC.

NPI Number 1982686861
LBN Legal business name VITAL WELLNESS HEALTHCARE, INC.
Authorized official ALLAN ROSALES - (CLINICAL OPERATION EXECUTIVE)
Entity Organization
Organization subpart 1 No
Enumeration date 11/16/2005
Last updated 10/03/2018 - About 8 years ago
Identifiers
IL License # 1010318
IL Medicaid 1982686861-001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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