Provider Demographics
NPI:1952626509
Name:VITAL HEALTH SCREENINGS, LLC
Entity Type:Organization
Organization Name:VITAL HEALTH SCREENINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BAGGETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:RCT, RDMS
Authorized Official - Phone:225-921-1832
Mailing Address - Street 1:18448 WILDLIFE WAY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-3992
Mailing Address - Country:US
Mailing Address - Phone:225-921-1832
Mailing Address - Fax:
Practice Address - Street 1:18448 WILDLIFE WAY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-3992
Practice Address - Country:US
Practice Address - Phone:225-921-1832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory