Vital Medical Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

002197618 Issued in CA

Legal business name

VITAL MEDICAL SUPPLY INC.

Practice address

4515 Eagle Rock Blvd
Suite 145C
Los Angeles, CA 90041-3214

Phone

(323) 550-8888

Fax

(323) 550-8881

NPI assigned

Jul 14, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Jose Gaviola

Title

President

Phone

(323) 550-8888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247529600000",
    "number": "1669601415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 EAGLE ROCK BLVD.",
            "address_2": "SUITE 145C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413214",
            "telephone_number": "323-550-8888",
            "fax_number": "323-550-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 EAGLE ROCK BLVD",
            "address_2": "SUITE 145C",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900413214",
            "telephone_number": "323-550-8888",
            "fax_number": "323-550-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL MEDICAL SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2009-07-14",
        "status": "A",
        "authorized_official_last_name": "GAVIOLA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-550-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "002197618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisha Viswanathan, M.D.
• Vita Health Solutions Inc
• Cristine Vita
• Vital Care Ambulance Inc
• Vital Health Medical Group, Inc.
• Vital Point Healthcare Corp
• Vital Scan Inc
• Vital Scope Medical Inc
• Vital Solutions Medical Group
• Vital Well

• Durable Medical Equipment & Medical Supplies in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; 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.