Vita Medicorp LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VITA MEDICORP LLC

Practice address

2020 W 3Rd St Ste 302
Little Rock, AR 72205-4464

Phone

(214) 709-1123

NPI assigned

Aug 28, 2024

Last updated

Sep 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Srikanth Reddy Molakatalla

Title

Business Owner

Phone

(214) 709-1123

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1356175756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W 3RD ST STE 302",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054464",
            "telephone_number": "214-709-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W 3RD ST STE 302",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722054464",
            "telephone_number": "214-709-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA MEDICORP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "MOLAKATALLA",
        "authorized_official_first_name": "SRIKANTH REDDY",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "214-709-1123"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.