NPIMap

Organization Active NPI

Vita Blue Homecare LLC

  • Home Health Agency
  • Philadelphia, PA
National Provider Identifier
1982185369
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
36523601 Issued in PA
Legal business name
VITA BLUE HOMECARE LLC
Practice address
2836 Tremont St
2
Philadelphia, PA 19136-1025
Phone
(610) 601-4591
NPI assigned
Aug 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Authorized official

Name
Dominique Duran, RNNPI 1831651546
Title
President/Administrator
Phone
(267) 979-1481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 36523601 PA Primary

Addresses

Primary practice location

2836 Tremont St
2
Philadelphia, PA 19136-1025

Mailing address

2836 Tremont St
2
Philadelphia, PA 19136-1025
Phone (610) 601-4591

Other identifiers 1

IdentifierTypeStateIssuer
103520828MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534982400000",
    "number": "1982185369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 TREMONT ST",
            "address_2": "2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361025",
            "telephone_number": "610-601-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2836 TREMONT ST",
            "address_2": "2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191361025",
            "telephone_number": "610-601-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA BLUE HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A",
        "authorized_official_last_name": "DURAN",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "267-979-1481",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "36523601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103520828",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.