Provider Demographics
NPI:1548060932
Name:VITAL HEALTHCARE LLC
Entity type:Organization
Organization Name:VITAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OFONAGORO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:617-993-4951
Mailing Address - Street 1:27 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2324
Mailing Address - Country:US
Mailing Address - Phone:617-888-9097
Mailing Address - Fax:
Practice Address - Street 1:27 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2324
Practice Address - Country:US
Practice Address - Phone:617-888-9097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health