Provider Demographics
NPI:1447927454
Name:VITAL HC, INC.
Entity type:Organization
Organization Name:VITAL HC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUKIASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-278-5003
Mailing Address - Street 1:1729 N TREKELL RD STE 122
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-2215
Mailing Address - Country:US
Mailing Address - Phone:520-278-5003
Mailing Address - Fax:520-268-9754
Practice Address - Street 1:1729 N TREKELL RD STE 122
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-2215
Practice Address - Country:US
Practice Address - Phone:520-278-5003
Practice Address - Fax:520-268-9754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based