Provider Demographics
NPI:1295845147
Name:VITAL CARE OF YORK COUNTY, INC.
Entity type:Organization
Organization Name:VITAL CARE OF YORK COUNTY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-980-0190
Mailing Address - Street 1:1514 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6146
Mailing Address - Country:US
Mailing Address - Phone:803-980-0190
Mailing Address - Fax:803-980-0213
Practice Address - Street 1:1514 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-6146
Practice Address - Country:US
Practice Address - Phone:803-980-0190
Practice Address - Fax:803-980-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC50008679332B00000X, 332BC3200X, 332BP3500X, 332BX2000X, 333600000X, 3336C0003X, 3336H0001X, 3336L0003X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE2408Medicaid
SC0426247Medicaid
=========OtherTRICARE DME
=========001OtherTRICARE HIT
SC0426247Medicaid
SC=========OtherBCBS HIT