Vital Care of Southwest Virginia, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0201004074 Issued in VA

Legal business name

VITAL CARE OF SOUTHWEST VIRGINIA, INC.

Doing business as

Vital Care of Southwest Virginia

Practice address

305 Old Kentucky Tpke
Cedar Bluff, VA 24609-9401

Phone

(276) 964-0555

Fax

(276) 964-2999

NPI assigned

Oct 20, 2014

Last updated

Oct 20, 2014By 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. Steven D. Williams

Title

Owner

Phone

(276) 964-0555

Specialties & licenses 4

Addresses

Other names 1

• Vital Care of Southwest Virginia Doing business as

Tax ID family

Vital Care of Southwest Virginia2 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 Care Southwest VA, Inc

  • Specialty Pharmacy
  • Cedar Bluff, VA
  • NPI 1811206915
  NPD tax ID

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1720482789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 OLD KENTUCKY TPKE",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246099401",
            "telephone_number": "276-964-0555",
            "fax_number": "276-964-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 OLD KENTUCKY TPKE",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246099401",
            "telephone_number": "276-964-0555",
            "fax_number": "276-964-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL CARE OF SOUTHWEST VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "276-964-0555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0201004074",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "VA",
            "license": "0201004074",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201004074",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "VA",
            "license": "0201004074",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Care of Southwest Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristen Denise Thompson-Whitt, MSN, APRN, FNP
• Justin Craig Trout, LPC
• Misty Dawn Vance, LCSW
• Victory Transports Inc
• Krista Vilacha
• Vital Care Southwest VA, Inc
• Vital Care Southwest Virginia, Inc.
• Whitley Gabrielle Wagner, LMHP-R
• Karen Yvonne Waldron, BA
• Anna Christine Wess, FNP-C

• Durable Medical Equipment & Medical Supplies in Cedar Bluff, VA
• Providers in Cedar Bluff, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.