Legal Business Name
Vital Rx Llc
Also Known As
Vital Rx
NPI Number
1710486410
NPI Type
Organization
Enumeration Date
02/08/2018
Specialties
(Taxonomies)Code
3336H0001X
3336M0002X
333600000X
3336S0011X
Primary Taxonomy
Yes
No
No
No
Licenses
State
Alabama
License Number
114629
Contact
Information
Purpose
Mailing
Location
Address
237 CAHABA VALLEY PKWY
237 CAHABA VALLEY PKWY
City
Pelham
Pelham
State
AL
AL
Postal Code
35124-1146
35124-1146
Country
US
US
Telephone Number
(866) 209-5540
(866) 209-5540
Authorized Official
Name
Jason Flebotte
Title or Position
PHARMACIST IN CHARGE
Telephone Number
(866) 209-5540
Identifiers
Identifier
189993
2175777
Identifier State
AL
Unknown
Identifier Issuer
Unknown
PK
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/08/2018