Organization
VITAL CARE SOUTHWEST VIRGINIA, INC.
Active
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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