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Organization
VITALFORT LLC
Active
Organization
VITALFORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD KHAN (OWNER)
(917) 525-2517
Entity
Organization
Contact information
Practice address
630 LAKE KNOLL DR NW, LILBURN, GA 30047-8709
(917) 525-2517
Mailing address
630 LAKE KNOLL DR NW, LILBURN, GA 30047-8709
(917) 525-2517
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BD1200X
Dialysis Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
09/16/2025
Last updated
06/23/2026
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