Provider Demographics
NPI:1154830487
Name:VITAL TELEMONITORING, LLC
Entity Type:Organization
Organization Name:VITAL TELEMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANCISO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-212-8005
Mailing Address - Street 1:929 E ESPERANZA AVE UNIT 26
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1472
Mailing Address - Country:US
Mailing Address - Phone:956-212-8005
Mailing Address - Fax:866-761-1958
Practice Address - Street 1:929 E ESPERANZA AVE UNIT 26
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-212-8005
Practice Address - Fax:866-761-1958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018553OtherHCSSA LICENSE