Provider Demographics
NPI:1992940142
Name:VITAPHONE U.S.A., CORPORATION
Entity type:Organization
Organization Name:VITAPHONE U.S.A., CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:F
Authorized Official - Last Name:TRITLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-374-1270
Mailing Address - Street 1:7140 DEAN MARTIN DRIVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-4518
Mailing Address - Country:US
Mailing Address - Phone:888-869-4015
Mailing Address - Fax:888-226-3339
Practice Address - Street 1:7140 DEAN MARTIN DRIVE
Practice Address - Street 2:SUITE 700
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-4518
Practice Address - Country:US
Practice Address - Phone:888-869-4015
Practice Address - Fax:888-226-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies