Organization
VITALITY HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOTOYA TATUM RN (CEO)
(919) 667-5287
Entity
Organization
Contact information
Practice address
4222 ANGIER AVE, DURHAM, NC 27703-5941
(919) 667-5287
Mailing address
PO BOX 21365, DURHAM, NC 27703-1365
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
11/03/2021
Last updated
01/15/2023
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