Organization
VITALITY CLINICAL ASSOCIATES LLC
Active
Other names
Flare MD
Organization subpart
No
Provider details
NPI number
Authorized official
RAINE CODDINGTON (ADMINISTRATOR)
(256) 714-5099
Entity
Organization
Contact information
Practice address
3001 HILL HEDGE DR, MONTGOMERY, AL 36111-1108
(256) 714-5099
Mailing address
102 VIRGINIA LN, ARLINGTON, TX 76010-5636
(256) 714-5099
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
—
—
163WE0003X
Emergency Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215319447
—
AL
Enumeration date
03/21/2025
Last updated
03/21/2025
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