Provider Demographics
NPI:1467558080
Name:VITAFLO USA, LLC
Entity Type:Organization
Organization Name:VITAFLO USA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SZYMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-527-7794
Mailing Address - Street 1:211 N UNION ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-2657
Mailing Address - Country:US
Mailing Address - Phone:631-972-8985
Mailing Address - Fax:631-693-2002
Practice Address - Street 1:211 N UNION ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2657
Practice Address - Country:US
Practice Address - Phone:631-972-8985
Practice Address - Fax:631-693-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY831695OtherTUFTS HEALTH PLAN
NYN96583OtherGUARDIAN HEALTH INSURANCE
NYVI0S75E810OtherEMPIRE BLUE CROSS