Vital RX LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

114629 Issued in AL

Legal business name

VITAL RX LLC

Doing business as

Vital Rx

Practice address

237 Cahaba Valley Pkwy
Pelham, AL 35124-1146

Phone

(866) 209-5540

Fax

(800) 878-4160

NPI assigned

Feb 8, 2018

Organization subpart

No

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

Authorized official

Name

Jason Flebotte

Title

Pharmacist in Charge

Phone

(866) 209-5540

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Vital Rx Doing business as

Tax ID family

Vital RX2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vital RX

  • Home Infusion Therapy Pharmacy
  • Pelham, AL
  • NPI 1407355480
  NPD tax ID

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1710486410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 CAHABA VALLEY PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241146",
            "telephone_number": "866-209-5540",
            "fax_number": "800-878-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 CAHABA VALLEY PKWY",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241146",
            "telephone_number": "866-209-5540",
            "fax_number": "800-878-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "FLEBOTTE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "866-209-5540"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "AL",
            "license": "114629",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189993",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2175777",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Catherine Vaughan, PT, DPT
• Thera Virginia Vaughan, MS, OTR/L
• John Joseph Vaughn
• Vital RX
• Vital RX
• Darryl Lynn Waid, D.M.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-5262)
• Wal-Mart Stores East, LP (Vision Center 30-5262)
• Walgreen Co (Walgreens #09427)
• Walgreen Co (Walgreens #04589)

• Home Infusion Therapy Pharmacy in Pelham, AL
• Providers in Pelham, AL by specialty
• Home Infusion Therapy Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.