Organization
VITAL LIFE INSTITUTE, LLC
Active
Other names
VitalRx
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA RISTUCCIA (PHARMACY MANAGER)
(941) 388-0800
Entity
Organization
Contact information
Practice address
1618 MAIN ST, SARASOTA, FL 34236-5811
(941) 388-0800
(941) 388-0810
Mailing address
1618 MAIN ST, SARASOTA, FL 34236-5811
(941) 388-0800
(941) 388-0810
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PH30105
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162504
PK
—
Enumeration date
06/21/2016
Last updated
12/06/2016
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