Provider Demographics
NPI:1851002000
Name:HEALTHVITALS,LLC
Entity Type:Organization
Organization Name:HEALTHVITALS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHYSICIAN EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:NKIRUKA
Authorized Official - Middle Name:SANDRA
Authorized Official - Last Name:NNEBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-407-5155
Mailing Address - Street 1:205 CHRISTINA LANDING DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5248
Mailing Address - Country:US
Mailing Address - Phone:302-407-5155
Mailing Address - Fax:
Practice Address - Street 1:802 N WEST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1526
Practice Address - Country:US
Practice Address - Phone:302-407-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty