Organization
VITAL RX LLC
Active
Other names
Vital Rx
Organization subpart
No
Provider details
NPI number
Authorized official
JASON FLEBOTTE (PHARMACIST IN CHARGE)
(866) 209-5540
Entity
Organization
Contact information
Practice address
237 CAHABA VALLEY PKWY, PELHAM, AL 35124-1146
(866) 209-5540
(800) 878-4160
Mailing address
237 CAHABA VALLEY PKWY, PELHAM, AL 35124-1146
(866) 209-5540
(800) 878-4160
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
114629
AL
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189993
—
AL
01
—
2175777
PK
—
Enumeration date
02/08/2018
Last updated
02/08/2018
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