Organization
VITAL CARE SOUTHWEST VA, 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
(276) 964-2999
Mailing address
PO BOX 5047, MERIDIAN, MS 39302
(601) 482-7420
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
0201004074
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412247
ANTHEM BCBS
VA
Enumeration date
10/07/2010
Last updated
10/07/2010
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