Vita O2 Inc.

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

VITA O2 INC.

Practice address

104 Colony Park Dr
Cumming, GA 30040-2792

Phone

(706) 265-8952

Fax

(706) 265-8953

NPI assigned

Oct 16, 2007

Last updated

Oct 16, 2007By 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

Mr. Jere Hyland

Title

Owner

Phone

(706) 265-8952

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1609065622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CHAPPELL RD",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305347497",
            "telephone_number": "706-265-8952",
            "fax_number": "706-265-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 COLONY PARK DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402792",
            "telephone_number": "706-265-8952",
            "fax_number": "706-265-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA O2 INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "HYLAND",
        "authorized_official_first_name": "JERE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-265-8952",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.