Provider Demographics
NPI:1558643064
Name:VITALANT
Entity Type:Organization
Organization Name:VITALANT
Other - Org Name:UNITED BLOOD SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-675-5506
Mailing Address - Street 1:6210 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-1101
Mailing Address - Country:US
Mailing Address - Phone:800-288-2199
Mailing Address - Fax:480-675-5676
Practice Address - Street 1:6210 E OAK ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-1101
Practice Address - Country:US
Practice Address - Phone:800-288-2199
Practice Address - Fax:480-675-5676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank