# VITALITY MEDICAL CENTERS OF CHARLESTON INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VMC of Charleston
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750820510
- **Authorized official:** MR. JASON B FARMER (OWNER)
- **Authorized official phone:** (803) 244-9212

## Contact information

- **Practice address:** 2679 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
- **Practice address phone:** (843) 480-0855
- **Mailing address:** PO BOX 7227, WEST COLUMBIA, SC 29171-7227
- **Mailing address phone:** (803) 244-9212
- **Mailing address fax:** (803) 708-0865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 02/13/2017
- **Last updated:** 03/05/2025