Provider Demographics
NPI:1336955715
Name:VITALITY CARE PLLC
Entity type:Organization
Organization Name:VITALITY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSILLIPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-599-7093
Mailing Address - Street 1:5601 SORRELL CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8301
Mailing Address - Country:US
Mailing Address - Phone:919-667-3318
Mailing Address - Fax:
Practice Address - Street 1:13312 CAMBRIDGE VILLAGE LOOP
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-7173
Practice Address - Country:US
Practice Address - Phone:984-223-9585
Practice Address - Fax:910-230-1948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty