Provider Demographics
NPI:1710397831
Name:VITAL HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:VITAL HOME CARE SERVICES, LLC
Other - Org Name:SUMMIT ORTHOPAEDIC HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURKAM
Authorized Official - Suffix:SR
Authorized Official - Credentials:PT
Authorized Official - Phone:614-554-7964
Mailing Address - Street 1:170 TAYLOR STATION RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4441
Mailing Address - Country:US
Mailing Address - Phone:614-866-8158
Mailing Address - Fax:614-866-8160
Practice Address - Street 1:1300 NW 17TH AVE
Practice Address - Street 2:SUITE 152
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2578
Practice Address - Country:US
Practice Address - Phone:561-734-1531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health