Provider Demographics
NPI:1083729255
Name:VITAL CARE OF AMERICA,INC
Entity Type:Organization
Organization Name:VITAL CARE OF AMERICA,INC
Other - Org Name:VITAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-487-9354
Mailing Address - Street 1:23257 ROUTE 7
Mailing Address - Street 2:207
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2391
Mailing Address - Country:US
Mailing Address - Phone:561-487-9700
Mailing Address - Fax:561-487-1055
Practice Address - Street 1:23257 ROUTE 7
Practice Address - Street 2:207
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2391
Practice Address - Country:US
Practice Address - Phone:561-487-9700
Practice Address - Fax:561-487-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4683470001Medicare NSC