Provider Demographics
NPI:1124661319
Name:VITAL NURSING CARE
Entity type:Organization
Organization Name:VITAL NURSING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:OTUZBIRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-404-0494
Mailing Address - Street 1:3017 N SAN FERNANDO BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4704
Mailing Address - Country:US
Mailing Address - Phone:888-404-0494
Mailing Address - Fax:
Practice Address - Street 1:3017 N SAN FERNANDO BLVD STE A
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91504-4704
Practice Address - Country:US
Practice Address - Phone:888-404-0494
Practice Address - Fax:888-404-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health