| Vital Healthcare Specialists | |
|
4338 W Thomas Rd # U1 Phoenix AZ 85031-3878 | |
| (775) 335-7450 | |
| Not Available |
| Full Name | Vital Healthcare Specialists |
|---|---|
| Speciality | Clinic/Center |
| Location | 4338 W Thomas Rd # U1, Phoenix, Arizona |
| Authorized Official Name and Position | Theophilus Akoh (MANAGING PARTNER) |
| Authorized Official Contact | 7753357450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Healthcare Specialists 4338 W Thomas Rd # U1 Phoenix AZ 85031-3878 Ph: (775) 335-7450 | Vital Healthcare Specialists 4338 W Thomas Rd # U1 Phoenix AZ 85031-3878 Ph: (775) 335-7450 |
| NPI Number | 1336767516 |
|---|---|
| Provider Enumeration Date | 07/14/2020 |
| Last Update Date | 08/31/2021 |
| Certification Date | 08/31/2021 |
| Medicare PECOS PAC ID | 3072930478 |
|---|---|
| Medicare Enrollment ID | O20200831002783 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336767516 | NPI | - | NPPES |
| Provider Name | Anita T Sassaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952644965 PECOS PAC ID: 1355589474 Enrollment ID: I20130601000027 |
| Provider Name | Vincent P Goux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598703217 PECOS PAC ID: 2567465289 Enrollment ID: I20141025000041 |
| Provider Name | Theophilus M Akoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275908444 PECOS PAC ID: 2466751102 Enrollment ID: I20200831002897 |
| Provider Name | Symonpeter Ndungu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053914564 PECOS PAC ID: 0345652004 Enrollment ID: I20201222001422 |
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