NPIMap

Organization Active NPI

Reisz Pharmaceuticals Vital Care, Inc.

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Owensboro, KY
National Provider Identifier
1164432126
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
License
P02023 Issued in KY
Legal business name
REISZ PHARMACEUTICALS VITAL CARE, INC.
Doing business as
Reisz Pharmaceuticals Vital Care
Practice address
2315 Mayfair Dr
Mayfair Square Professional Building
Owensboro, KY 42301-4557
Phone
(270) 683-7379
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
E Reisz
Title
Owner
Phone
(270) 683-7379

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X P02023 KY Primary

Addresses

Primary practice location

2315 Mayfair Dr
Mayfair Square Professional Building
Owensboro, KY 42301-4557

Mailing address

PO Box 5047
Meridian, MS 39302-5047

Other identifiers 6

IdentifierTypeStateIssuer
54029384MedicaidKY
000000069966OtherKYBCBS
1445572OtherUMWA
90140302MedicaidKY
61128006OtherCHAMPUS/TRICARE
4055675OtherTNBCBS, NON-PAR

Other names 1

  • Reisz Pharmaceuticals Vital Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reisz Pharmaceuticals Vital Care8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164432126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5047",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 MAYFAIR DR",
            "address_2": "MAYFAIR SQUARE PROFESSIONAL BUILDING",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014557",
            "telephone_number": "270-683-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REISZ PHARMACEUTICALS VITAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REISZ",
        "authorized_official_first_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-683-7379"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "KY",
            "license": "P02023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54029384",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000069966",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1445572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90140302",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "61128006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS, NON-PAR",
            "identifier": "4055675",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reisz Pharmaceuticals Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.