Provider Demographics
NPI:1306081955
Name:VIGORWORKS, LLC
Entity type:Organization
Organization Name:VIGORWORKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BOTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-545-2000
Mailing Address - Street 1:PO BOX 25817
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-5817
Mailing Address - Country:US
Mailing Address - Phone:215-545-2000
Mailing Address - Fax:
Practice Address - Street 1:313 SAGE LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-4556
Practice Address - Country:US
Practice Address - Phone:215-545-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
PADN003988133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty