Provider Demographics
NPI:1952738098
Name:VITALMEDRX
Entity type:Organization
Organization Name:VITALMEDRX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:LEMARR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:888-614-0688
Mailing Address - Street 1:235 E MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-2342
Mailing Address - Country:US
Mailing Address - Phone:888-614-0688
Mailing Address - Fax:
Practice Address - Street 1:235 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-2342
Practice Address - Country:US
Practice Address - Phone:888-614-0688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5043333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy