Provider Demographics
NPI:1629758230
Name:VITALITY INFUSIONS LLC
Entity Type:Organization
Organization Name:VITALITY INFUSIONS LLC
Other - Org Name:VITAL CARE OF BUFFALO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/VP FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-676-6655
Mailing Address - Street 1:3980 SHERIDAN DR STE 101
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1741
Mailing Address - Country:US
Mailing Address - Phone:716-676-6655
Mailing Address - Fax:716-677-6656
Practice Address - Street 1:3980 SHERIDAN DR STE 101
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1741
Practice Address - Country:US
Practice Address - Phone:716-676-6655
Practice Address - Fax:716-677-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy