# VITAL ENERGY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962697771
- **Authorized official:** HIMA N DALAL OT (OWNER)
- **Authorized official phone:** (803) 233-3049

## Contact information

- **Practice address:** 1812 AUGUSTA HWY STE L, LEXINGTON, SC 29072-1915
- **Practice address phone:** (803) 233-3049
- **Practice address fax:** (203) 233-9201
- **Mailing address:** 121 CLEARVIEW DR, COLUMBIA, SC 29212-8304

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 2626 | SC | Yes |

## Other

- **Enumeration date:** 09/14/2007
- **Last updated:** 09/14/2007