Provider Demographics
NPI:1407471550
Name:VITAL CONNECT, INC
Entity Type:Organization
Organization Name:VITAL CONNECT, INC
Other - Org Name:VITAL CONNECT INDUSTRIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VITAL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNECT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-963-4600
Mailing Address - Street 1:2870 ZANKER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2133
Mailing Address - Country:US
Mailing Address - Phone:408-963-4600
Mailing Address - Fax:
Practice Address - Street 1:2870 ZANKER RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-2133
Practice Address - Country:US
Practice Address - Phone:408-963-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty