Organization
VITAL LIFE PHARMACY
Active
Organization
VITAL LIFE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BALAREZO PHARMD (OWNER)
(954) 871-7633
Entity
Organization
Contact information
Practice address
6063 SW 18TH ST, BAY 112, BOCA RATON, FL 33433-7118
(561) 245-7082
Mailing address
6063 SW 18TH ST, BAY 112, BOCA RATON, FL 33433-7118
(561) 245-7082
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH28149
FL
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up