Provider Demographics
NPI:1427839877
Name:VITA BEATA HEALTH, LLC
Entity type:Organization
Organization Name:VITA BEATA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BENTZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-854-9163
Mailing Address - Street 1:6490 ROAD 18
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-9000
Mailing Address - Country:US
Mailing Address - Phone:785-728-2929
Mailing Address - Fax:
Practice Address - Street 1:2215 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-9715
Practice Address - Country:US
Practice Address - Phone:785-728-2929
Practice Address - Fax:785-728-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care