Organization
VITAL DME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL D CLARK CPA (CEO)
(504) 835-4000
Entity
Organization
Contact information
Practice address
59 5TH ST, GRETNA, LA 70053-4744
(504) 263-0865
(504) 263-0866
Mailing address
PO BOX 8832, METAIRIE, LA 70011
(504) 835-4000
(504) 835-4999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
260011299
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1590339
—
LA
Enumeration date
01/24/2006
Last updated
04/18/2013
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