Provider Demographics
NPI:1235954389
Name:VITALCARE HEALTH SERVICES PC
Entity type:Organization
Organization Name:VITALCARE HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHANCEQ
Authorized Official - Middle Name:
Authorized Official - Last Name:BASINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:505-320-9952
Mailing Address - Street 1:3079 N 3550 W
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7514
Mailing Address - Country:US
Mailing Address - Phone:505-320-9952
Mailing Address - Fax:
Practice Address - Street 1:3079 N 3550 W
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7514
Practice Address - Country:US
Practice Address - Phone:505-320-9952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care