Vitality Medical Dispensary, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

VITALITY MEDICAL DISPENSARY, INC.

Practice address

103 Sum Mor Dr
West Columbia, SC 29169-4828

Phone

(803) 244-9212

NPI assigned

Dec 16, 2016

Organization subpart

No

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

Authorized official

Name

Daniel Handford

Title

Director

Phone

(803) 218-9886

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1481846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1275077802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1320",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290711320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 SUM MOR DR",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694828",
            "telephone_number": "803-244-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY MEDICAL DISPENSARY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-16",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "HANDFORD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "803-218-9886"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrance Screening and Wellness LLC
• Wilfredo Austin Villarrubia, PA-C
• Zackary Stark Vincent, MD
• Vision Therapy Institute of SC (Vision Therapy Institute)
• Vitality Medical Centers, Inc.
• Thanh Vo
• Samuel Wachter, APRN
• Veronica S. Wactor, NP
• Summer Wadford
• Kari L. Wagner, PSY.D.

• Physical Medicine & Rehabilitation Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Physical Medicine & Rehabilitation Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.