Provider Demographics
NPI:1316942055
Name:VITALMED, INC.
Entity type:Organization
Organization Name:VITALMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:FREDERIC
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-288-8119
Mailing Address - Street 1:221 W ONTARIO DR
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-6401
Mailing Address - Country:US
Mailing Address - Phone:765-288-8119
Mailing Address - Fax:765-289-8191
Practice Address - Street 1:221 W ONTARIO DR
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-6401
Practice Address - Country:US
Practice Address - Phone:765-288-8119
Practice Address - Fax:765-289-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-18
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN00071297930026332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1191520002Medicare NSC