Organization Active NPI

Sartin'S Vital Care, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Gulfport, MS
National Provider Identifier
1932133196
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
08961 1/2.1 Issued in MS
Legal business name
SARTIN'S VITAL CARE, INC.
Practice address
1311 Broad Ave
Gulfport, MS 39501
Phone
(228) 864-7056
Fax
(228) 864-2402
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Alvin Sartin
Title
Pres
Phone
(228) 864-7056

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 08961 1/2.1 MS Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 08961 1/2.1 MS
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 08961/2.1 MS
Home Infusion Therapy Pharmacy 3336H0001X
Specialty Pharmacy 3336S0011X 08961 1/2.1 MS

Addresses

Primary practice location

1311 Broad Ave
Gulfport, MS 39501

Mailing address

1311 Broad Ave
Gulfport, MS 39501-2419
Phone (228) 864-7056

Other identifiers 2

IdentifierTypeStateIssuer
00040011MedicaidMS
2132187OtherPK

Other names 1

  • Sartins Vital Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110920000478 MS DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 8820061781 Practice locations: Gulfport, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Sartins Vital Care Inc1311 Broad Ave, Gulfport, MS 39501-2419(228) 864-7056 Epoetin|Immunosuppressive Drugs|Infusion Drugs|External Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment and/or Supplies Accepts assignmentParticipating since Jan 1, 2020

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4300 15th St
#A
Gulfport, MS 39501
Phone (228) 864-7056

4300 15th St
Ste 3
Gulfport, MS 39501
Phone (228) 864-7056

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1932133196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012419",
            "telephone_number": "228-864-7056",
            "fax_number": "228-864-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-864-7056",
            "fax_number": "228-864-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARTIN'S VITAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "SARTIN",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "228-864-7056"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "08961 1/2.1",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MS",
            "license": "08961 1/2.1",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "08961/2.1",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MS",
            "license": "08961 1/2.1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040011",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sartins Vital Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sartins Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.