Vital Pharmacy Group, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VITAL PHARMACY GROUP, INC.

Practice address

4971 Broadway
New York, NY 10034-1651

Phone

(917) 388-2622

Fax

(917) 388-2151

NPI assigned

May 31, 2024

Organization subpart

No

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

Authorized official

Name

Min Kim

Title

President

Phone

(551) 404-3942

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joon Kim, PHARM.D.

  • Pharmacist
  • New York, NY
  • NPI 1811201783
  NPD

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1295575728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341651",
            "telephone_number": "917-388-2622",
            "fax_number": "917-388-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4971 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341651",
            "telephone_number": "917-388-2622",
            "fax_number": "917-388-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PHARMACY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "551-404-3942"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Balance Healing Center Inc
• Vital Balance Nutrition LLC
• Vital Care Pharmacy Corp (207 Pharmacy)
• Vital Dental
• Vital Link Medical Equipment Incorporated
• Vital Point Medicine, P.C.
• Vitalcheck Wellness
• Christina Vitale, CCC-SLP
• Elizabeth Chopin Vitale, NP
• Kelly M Vitale, CPNP

• Community/Retail Pharmacy in New York, NY
• Providers in New York, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.