| Vital Health Llc | |
|
111 Clinton St Maumee OH 43537-2811 | |
| (197) 403-0224 | |
| (419) 740-3033 |
| Full Name | Vital Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 111 Clinton St, Maumee, Ohio |
| Authorized Official Name and Position | Nicole M Spellis-freyre (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4197403022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Health Llc 111 Clinton St Maumee OH 43537-2811 Ph: (419) 740-3022 | Vital Health Llc 111 Clinton St Maumee OH 43537-2811 Ph: (197) 403-0224 |
| NPI Number | 1952068843 |
|---|---|
| Provider Enumeration Date | 11/26/2021 |
| Last Update Date | 09/29/2023 |
| Medicare PECOS PAC ID | 4486048634 |
|---|---|
| Medicare Enrollment ID | O20220303002103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952068843 | NPI | - | NPPES |
| Provider Name | Naghmana Masood |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1912950361 PECOS PAC ID: 6204803687 Enrollment ID: I20040917001183 |
| Provider Name | Kemunto Mokora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295303386 PECOS PAC ID: 6507212677 Enrollment ID: I20231025002520 |
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