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Organization

VITAL CARE SOUTHWEST VIRGINIA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THERESA MORROW (PRESIDENT)
(276) 964-0555
Entity
Organization

Contact information

Practice address
305 OLD KENTUCKY TURNPIKE, CEDAR BLUFF, VA 24609
(276) 964-0555
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0201004074
VA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0201004074
VA
333600000X
Pharmacy
0201004074
VA
3336H0001X
Home Infusion Therapy Pharmacy
0201004074
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010265541
VA
05
010265550
VA
01
4839176
NCPDP
VA
01
611242400
FECA DME
01
7594801
AETNA
VA
Enumeration date
07/13/2006
Last updated
12/23/2013
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