Organization
VCISWV, LLC
Active
Other names
Vital Care Infusion Services of Glendale
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN KRAWETZ (OWNER)
(602) 848-2202
Entity
Organization
Contact information
Practice address
5422 W THUNDERBIRD RD STE 18, GLENDALE, AZ 85306-4717
(602) 848-2202
(602) 926-2500
Mailing address
5422 W THUNDERBIRD RD STE 18, GLENDALE, AZ 85306-4717
(602) 848-2202
(602) 926-2500
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Enumeration date
03/19/2025
Last updated
05/02/2025
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