Vitality Care Center Pllc

LBN: Vitality Care Center Pllc
Vitality Care Center Pllc is an health care organization with primary practice located at 1003 Division St Ste 8 , Prescott AZ 86301-1657. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Vitality Care Center Pllc can be contacted via phone (928) 632-0730, or through Krugman, Clarke via phone (928) 713-8385.

Contact Information

Primary practice address
1003 Division St Ste 8 Prescott AZ 86301-1657
Phone: (928) 632-0730
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Krugman, Clarke Nurse Practitioner (NP)
Phone: (928) 713-8385

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1114575578
LBN Legal business name Vitality Care Center Pllc
DBA Doing business as
Authorized official Krugman, Clarke Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 29th, 2019
Last updated Mar 10th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114575578 NPPES
Arizona MEDICAID 530064

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