Organization
VITAL ENTERPRISES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH HARRINGTON (CHIEF EXECUTIVE OFFICER)
(209) 339-7996
Entity
Organization
Contact information
Practice address
1115 S FAIRMONT AVE, LODI, CA 95240-5500
(209) 339-7610
Mailing address
1115 S FAIRMONT AVE, LODI, CA 95240-5500
(209) 339-7610
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
100178
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME00603G
—
CA
Enumeration date
06/25/2006
Last updated
08/22/2020
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