Provider Demographics
NPI:1508542614
Name:VITA HEALTH
Entity Type:Organization
Organization Name:VITA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-517-6590
Mailing Address - Street 1:427 SNELLING AVE N APT 606
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3980
Mailing Address - Country:US
Mailing Address - Phone:612-517-6590
Mailing Address - Fax:
Practice Address - Street 1:427 SNELLING AVE N APT 606
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3980
Practice Address - Country:US
Practice Address - Phone:612-517-6590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health