Vital Care HS, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00988600 Issued in NJ

Legal business name

VITAL CARE HS, LLC

Practice address

9 Normandy Rd
Marlton, NJ 08053-5525

Phone

(856) 552-0449

Fax

(856) 552-0187

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Irma Tetruashvily, MPT

Title

Physical Therapist Owner

Phone

(856) 985-5428

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689769754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NORMANDY RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535525",
            "telephone_number": "856-552-0449",
            "fax_number": "856-552-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NORMANDY RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080535525",
            "telephone_number": "856-552-0449",
            "fax_number": "856-552-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL CARE HS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TETRUASHVILY",
        "authorized_official_first_name": "IRMA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST OWNER",
        "authorized_official_telephone_number": "856-985-5428",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00988600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vita Counseling Services LLCS
• Vivienne Irene Matalon MD PC
• Cristina Vlas, FNP
• Voorhees Pain Consultants PA
• Michael John Voyack, D.O.
• Mary Agnes Wagas, MD

• All providers in Marlton, NJ
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.